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<br />110 and 111 Enclosure <br />Permittee Name: Leonard W Lloyd <br />Permit No: M-80-228- <br />Operation Name: Triangle 6ne Pit ~ ~ ~, <br />Anniversary Date: 04 / 27 / 85 " <br />Please complete the following and return this form with your fees ~d ' <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 />i <br />~/ <br />.<. <br />I <br />L~L ~ 6r3~~5 <br />Signature ~'~- <br />c ~~- <br /> <br />