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<br /> <br />110 Enclosure <br />Harold Brandstadt <br />Permittee Name: M-86-004 <br />Permit No: Brandstadt Rock Pit <br />Operation Name: 01/24/87 <br />Anniversary Date: <br />.,i4 a "" I~'~~ <br /> <br /> <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 />-% Q n) iJ ~ A L ~~ Po 2T <br />,La-cry 7.~0 ~a.~e~ , <br />Signature <br />~/~. jig <br />~. ~~ <br />r,~(~. <br />