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•'~ <br />~~ <br />112 Attachment <br />Permittee Name: Northern Colorado Water Conservancy District <br />Operation Name: WINDY GAP BORROW AREA C <br />Permit No: 81-86 <br />Anniversary Date: July 21 <br />Operator: <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) _ ~~ <br />~~~ Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />~-~ Annual Report <br /> <br />~-~ Map <br />Remarks: <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1805 <br />