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4 <br />n <br />~, <br />i ~ <br />112 Attachment <br />Permittee Name <br />Operation Name <br />Terra Construction ~OmDanY <br />Vollmer Pit <br />Permit No: 83-35 <br />Anniversary Date: May 13 <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 />I XI Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />I X I Annual Report , <br />I X I Map <br />Remarks: Mr. Claude Thompson, General Manager for Palisade Construction <br />Company's Colorado Springs operation, supplied the above information. The <br />initial excavation was completed 45.days prior to the anniversary date of <br />Mav 13. 1984. <br />Signature <br />an Holmquist <br />(Rev. 5/84) <br />Doc. No. 1805 <br />