Laserfiche WebLink
<br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br /> <br />112 Enclosure <br />• K ~ ` <br />Butala Const Co <br />M-77-170- <br />BUTALA GRAPE PIT <br />10 / O1 /~ <br />86 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />X Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />_~ Annual Report <br />X Map <br />Remarks: <br />gnature <br />