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_~. .: <br /> <br />y- ~ <br />110 and 111 Enclosure <br />Permittee Name: Nickolaus Arnusch <br />Permit No: M-81-287 <br />Operation Name: ARNUSCH GRAVEL PIT #3 <br />Anniversary Date: February 25 <br />Please complete the fo]lowing and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check spaces} below} <br />_.__L Check or money order payab]e to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />Remarks: ~~~M~~r, r <br /> <br />Signature <br />