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_ ~ III IIIIIIIIIIIIIIII ~,~~~~ <br />- ~ ,r'4t ~ 7 13~~'_~ <br />110 Enclosure <br />' ~11 pp,Fg71C1Mi n <br />Permittee Name: Walsenburg Sand & Gravel, Inc. <br />Kermit No: M-78-283 <br />Operation Name: Sand Arroyo <br />Anniversary Date: 04/24/90 <br />Total: E50.00 (Due on the Anniversary Date) <br />Please return this form with your completed Annual Report and a check or <br />money order for annual fees due, payable to the Colorado Mined Land Reclamation <br />Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203. <br />ANNUAL REPORT: <br />A ~ ~ yl <br />Signature _ <br />~~` <br />~ fn~,~1 t~la <br />