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<br /> <br />112 Attachment <br />Permittee Name: Palisade Copstruction Co <br />Operation Name: <br />Permit No: 77-132 <br />Anniversary Date: January 16 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />I~Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />~=' Annual Report <br />I_I Map <br />Remarks: _ <br />/~C/..P a <br /> <br /> <br />eSe ~ <br />(Rev. 5/84) <br />Doc. No. 1805 <br />