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• 112 Enclosure <br /> Permittee Name: Flatiron Paving Co <br /> Permit No: M-74-070- <br /> Operation Name: NELSON PIT <br /> Anniversary Date: 02 / 07 / 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 /> V/ Annual Report <br /> ✓ Map <br /> Remarks• <br /> Signature <br />