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- .. <br />Permit No: 80-246 <br />Anniversary Date: February 28 <br /> <br />Operator: <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />X Check or money order payable to the Colorado Mined Land <br />_ Reclamation Division for annual fees due <br />Annual Report <br />~ (see below) <br />Remarks : G},,,. i 1 arj matari al i c c}i 11 1matEd on 117E site. 47e hone <br />to be able to use the material this suRrer. V7e have not crushed material <br />on the site since 1981. <br /> <br />PUEBip PAVING, INC. <br />Signatu <br />