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~I r <br />111/112 Enclosure <br />Permittee Name: Transit Mix Concrete <br />Permit No: M-73-007SG <br />Operation Name: Daniels Sand Pit 2 <br />Anniversary Date: O1 / 07 / 87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: iCheck space(s) below) <br />XX Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due CHK. N0. 35906 (date: 1/5/87) <br />XX Annual Report <br />XX Map <br />Remarks: PLEASE REFER TO THE ENCLOSED REPORT AND MAPS. <br />/ ~~ <br />~~ <br />G ~ ,~. <br />Signature <br />