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112 Attachment <br /> Permittee Name: Ideal Basic Industries, Inc. <br /> Operation Name: Portland Quarry <br /> Permit No : 77-334 <br /> Anniversary Date : October 10, 1986 <br /> Please complete the following and return this form with your fees and <br /> reclamation data. <br /> Enclosed are: (Check box(es) ) <br /> Ig l Check or money order payable to Colorado Mined Land <br /> Reclamation Division for annual fees due <br /> $350,00 <br /> ICI Annual Report <br /> ix I <br /> Map <br /> Remarks: <br /> 0,<,2 1O� <br /> O�O <br /> nf. <br /> Signature Paul E. Thomsen <br /> (Rev. 5/84) <br /> Doc. No. 1805 <br />