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l ~ ~ =-~T11/112 Enclosure <br />r,rn ~ ~ ~sss <br />Permittee Name: Webster Sand & Gravel <br />Permit No: M-81-235 _ . <br />Operation Name: West Tennessee <br />Anniversary Date: 04/22/88 <br />r <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 payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Map <br />Signature <br />7381G <br />0054f <br />