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.,> iiii iiiiiiiiniu iii .,~ <br />110 and 111 Enclosure <br />Permittee Name: Delta Sand & Gravel <br />Permit No: M-77-022- <br />Operation Name: Pit No 3 <br />Anniversary Date: 03 / 28 / 85 <br />~!~C~~~ 2 ~ 19~C, <br />•-• ,, ;. <br />.:s <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />/_ Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks: ~~~ h-`7~R~~a~ <br />~`~~*q~ r ~.i3~c <br />~~.".l ~~ r ,- <br />-- _ <br />3~y~~~ .ro~ti` ^/~~ <br />ure <br />