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<br />~ iii iiiiiiiiiiiii iii ~ ~ ~ _~~~ <br />~- <br />112 Attachment <br />Permittee Name: Sterling Sand &/vGravel pC!'~~~~D /n~n~ <br />Operation Name: 57~~~ JN ~ ~ f l ~' l~Cl fY'//y'' <br />Permit No: 77-439 OCT 2~ )gad /~ <br />MINED LAND REi`LAMATImy~ <br />Anniversary Date: October 26 Colo. Dept. of iV?turai,~av~r <br />Please complete the following 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 '706.0 0 <br />I-I Annual Report <br />I-I Map <br />Remarks: The Annual I~port and Map will be submitted by Rindahl & Associates. <br />~ ~ I _ ~ ~ <br />Signature <br />(Rev. 5/84) <br />Doc. No. 1805 <br />