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_ ~~ ~ ~ III IIIIIIIIIIIIIIII ~ <br />Permittee Name: Ideal Basic <br />Operdtlon Name: Boettcher Gypsum f~uarry <br />Permit No: 77-346 <br />Anniversary Date: October 10, 1985 <br />112 Attachment <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />I xl Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />$350.00 <br />I X I Annual Report <br />Igl Map <br />Remarks: <br />~ ~' ~, ~ RECEIV'LO- <br />Signature <br />OCT ~ 91985 <br />(Rev. 5/84 ) MIIiEO lJ1ND <br />Doc. No. 1805 <br />RECWr1A,T1ON pIWS1ON <br />