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• RE C E IVE®111 /112 Enclosure <br /> Permittee Name: General Refact Co <br /> MAR 181987 <br /> Permit No: M-77-219 MINED LAND <br /> Operation Name: Beulah Mine RECLAMATION DIVISION <br /> Anniversary Date: 03/22/87 <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 L <br /> Remarks: <br /> Signature / <br /> (Rev. 02/87) <br /> 5257F 9yt , <br /> ' F �eo00 <br />