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' r • <br /> 112 Enclosure <br /> Permittee Name: Western Paving Const <br /> Permit No: M-83-067- <br /> Operation Name: STAGE COACH STOP PIT <br /> Anniversary Date: 07 / 03 / 86 <br /> Please complete the following and return this form with your fees and <br /> reclamation data. <br /> Enclosed are: (Check space(s) below) <br /> x Check or money order payable to Colorado Mined Land Reclamation <br /> Division for annual fees due <br /> Annual Report - See Remarks <br /> Map - See Remarks <br /> Remarks: This is still all agricultural land and there has been no activity <br /> during the past year <br /> Signature Frank M. Graham, Jr. <br />