Laserfiche WebLink
• - • . <br />112 Enclosure <br />Permittee Name: ~~~p~~'~ <br />Permit No: Denver Brick Co 9~ r'r"' <br />Operation Name: M-77-392- <br />Anniversary Date: DAWSON STATE LEASE <br />03 / 11 / 66 APR 14 1986 <br />Please com lete the followin and return this form with our fees M'M~ ~AN© f~~~t_AF.4aT(~p~ <br />P 9 Y ~fIO. QL~t. Ot ~;Eis'19~ AISfr31?4:iti <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 <br />X Map <br />Remarks: IMPORTANT: Please change the mailing address on your <br />computer and card files to: <br />The Denver Brick Company <br />P.0. Box 130 <br />Castle Rock, CO 80104, 688-6952 <br />~ ~~-~ <br />Signature <br />Consultant to <br />The Denver Brick Company <br />