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~. <br />- ~ ~ ~ III Iiilliilllliiill <br />999 <br />Permittee Name: Mountain Aggregates Const Co <br />Permit No: M-78-279 <br />- Operation Name: Goldman Gravel Pit <br />Anniversary Date:ll/22/86 <br />110 Enclosure <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 pdyable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks: <br />Signature <br />^. <br /> <br />