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I <br /> 111/112 Enclosure <br /> Permittee Name: General Refact Company <br /> Permit No: M-77-219 <br /> Operation Name: Beulah Mine <br /> Anniversary Date: 03/22/89 <br /> Please complete the following and return this farm 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 /> v Map <br /> Remarks: <br /> Signature <br />