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• ~II ~I~~I~~I~~~~~ ~I~ <br />sss <br />Permit No: 82-129 ROCKY FLAT GRAVEL <br />Hnniversary Date: August 5 <br />Operator: <br /> <br />R~c~avE® <br />SEP 1G 1983 <br />Ml Coo Dept of NaloAallResourcesON <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(esj) <br />Check or money order payaole to Coloraao Minea Land <br />Reclamation Division for annual fees due <br />Annual Report <br />Remarks: <br /> <br />~~~ <br />%'LI~Z Cam/ ~ i s--~e.i ~ ~-¢~~ <br />~y~ ~~~:~-t~~- ~~ ~~ <br />- i d ~~f 4 ~e~~~ ~ <br />Signature <br />