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<br />112 Enclosure <br />Permittee Name: Charles R. Nauta <br />Permit No: M-85-784 <br />Operation Name: Pit#2 <br />Anniversary Date: January 22, 1986 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />XX Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />XX Annual Report <br />~_ Map <br />Remarks: <br />Signature <br />