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~~ ~- iiiiiiiiiiiiiiiiiii • <br />• <br />112 Enclosure <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Braley Sand & Gravel <br />M-80-020- <br />BRALEY S&G PIT NO 1 <br />07/15/86 <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 />Map <br />~(~-"' <br />P <br />~o ~ 3~~ <br />