_REPORT - M1981302

• Permit No: M1981302
• IBM Index Class Name: Report
• Doc Name: ANNUAL MONITORING REPORT
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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PLEA'-7ETACH THIS REMITTANCE BEFORE DEPOSITING CHECY
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Co NENWR B PAYEE NAME CHECK ww¢E
NO. NUMBEN 4 NUMBER NUMBER
2 000 1INED LAND f2ECLA".IIIIIIIIIIIATION
ANNUAL FEE — DEEPE PIT 081-302
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]OB COSTOL GENERAL
L NUMBEN EM LEDGER
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E DATE DATE MOuNi 0 (BLANK) C1. AGET.NO
F NUMBER CODE CODE
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D Mw pD
350j00 P 50.00
PAYMENT TO THE ACCOUNT OF
FLATIRON SAND AND GRAVEL COMPANY
P.O.BOX 229 BOULDER,COLORADO 5
e
REQUESTED BY: r3SI/df 10-1/31/24
DATE PREPARED: i i
MD. DAY YR.
MINED LAND RECLAMATION D 123 2 I R
' A 1313 Sherman Street Room 413
Denver, CO 80203
( - (30 6-3567
RECEIVED FROM —6
THE SUM J� L RS $ •-�( ',//� /(
FOR (^�' nnn cr;
AMOUNT OF ACC:OUNT......$ " I aRk `I ou
AMOUNT PAID................$ lJ 1� `J
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BALANCE DUE...............$