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<br />Permittee Name; <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Cf&i Steel Corp <br />M-77-376- <br />CANON DOLOMITE QUAR <br />09/22/85 <br />112 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 />4 <br />Remarks: <br />Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Map <br /> <br />Signature <br />