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112 Enclosure <br /> Permittee Name: Cooley Gravel Co <br /> Permit No: M-73-021 - <br /> Operation Name: MORRISON QUARRY <br /> Anniversary Date: 05 / 23 / 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 /> Check or money order payable to Colorado Mined Land Reclamation <br /> Division for annual fees due <br /> Annual Report <br /> Map <br /> Remarks: <br /> Signature <br />