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112 Attachment <br /> Permittee Name: Ideal Basic <br /> Operation Name: Portland Quarry <br /> Permit No: 77-344 <br /> Anniversary Date: October 10, 1985 <br /> Please complete the following and return this form with your fees and <br /> reclamation data. <br /> Enclosed are: (Check box(es) ) <br /> IX I Check or money order payable to Colorado Mined Land <br /> Reclamation Division for annual fees due <br /> $350.00 <br /> Ix I Annual Report <br /> Ix I Map <br /> Remarks: <br /> Signature R ECEIV D <br /> (Rev. 5184) OCT 9 985 <br /> Doc. No. 1805 <br /> MINED LAND <br /> RECLAMATION DIVISION <br />