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r~ <br /> <br />Permittee Name: <br />Operation Name: <br />Permit No: <br />Anniversary Date: <br />Please complete t <br />reclamation data. <br />~ III IIIIIIIIIIIIIIII ~, ~~ <br />110 and 111 Attachment <br />Builders Aggregate <br />BUILDERS AGGREGATE <br />sI-II2 <br />September 1 <br />he following and reti <br />Enclosed are: (Check box(es)) <br />Company, Inc. <br />PIT ~~~~~ v ~® <br />ACT " 3 ]g84 <br />PAINED (q ND <br />Colo. Deft. ofENat ~a/lR aD~CeSfON <br />irn this form with your fees and <br />~~ Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />~L-' Annual Report <br /> <br />re <br /> <br />(Rev. 5/84) <br />Doc. No. 1782 <br />