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<br />112 Attachment <br />Permittee Name: Cecil E. & Kenneth D. Bettger <br />Operation Name: BETTGER GRAVEL PIT <br />Permit No: 76-51 <br />Anniversary Date: _May 8 <br />,,,~ <br />Please complete the fol]owing and return this form with your fees and <br />reclamation data. ' <br />Enclosed are: (Check box(es)) <br />~~I Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />Annual Report <br />Map <br />Remarks: <br />(Rev. 5/84) <br />Doc. No. 1805 <br />