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<br />111/112 Enclosure <br />Permittee Name: <br />Permit No: Flatiron Materials Co <br />Operation Name: M-79-097 <br />Anniversary Date: East Rigden Pit <br />06/13/87 <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 />V Annual Report <br />(/ Map <br />Remarks: <br />Signature <br />(Rev, 02/87) <br />5257E <br />