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• _ _ ~ • III IIIIIIIIIIIII III <br />110 and,,,lll_Enclosure <br />Permittee Name: Arts Fertilizer Co <br />Permit No: M-80-205 ~ ~ ~~ 1 0 ~g&6 <br />Operation Name: Arts Fertilizer Co <br />Anniversary Date: 10/02/86 r•• <br />.'~..c _ ... , <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 /> <br />Remarks: <br />/lle <br />~ ~ <br />Signature <br />(v/~o (gb <br />Gyn . ~- <br />~ ~~~ <br />