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_. _ • • - <br />112 Enclosure <br />Permittee Name: Sievers Ranch and Development Company <br />Permit No: M-77-98 <br />Operation Name: Sievers Ranch Pit <br />Anniversary Date: 06 / 30 / 86 <br />Please complete the following and return this form with your fees <br />and reclamation data. <br />Enclosed are: (Check space(s) below) <br />~_ Check or money order payable to Colorado Mined Land Reclama- <br />tion Division for annual fees due <br />~~ Annual Report <br />~(~ Map <br />Remarks: <br />Signature <br />