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• i <br />111/112 Enclosure <br />Permittee Name: Cooley Gravel Company <br />Permit No: M-76-009HR <br />Operation Name: Menzer Quarry <br />Anniversary Date: 06/23/88 <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 />Annual Report <br />Map <br />Remarks: /i'~'~i~~i~if <br />~ (G`'/J~'!'T {/~, ~-~"F~~ . AILL~ c~~zLfF F ` ~ CGGGf'/~ <br />Signature <br />(Rev. 02/88) <br />5257E <br />0054f <br />