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~ III11111111111~~~~~ <br />~~ • ~--- <br />~~ ~^ ~p~ ~1"~ Encl osure <br />FEB 191988 <br />Permittee Name: Mountain Gravel &`Const Co <br />Permit No: MINED LAND <br />Operation Name: M-83-028 [DECLAMATION DIVI51ON <br />Anniversary Date: Wallace Pit <br />02/24/88 <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 <Sc~ ~c2v W <br />Remarks : 'Tff~/~c' uJE~2E /LSO a~~~ rTO~S <br />/,tJ 7~//s Pi i /.rJ 7~/~ Lfts~ Y~9.e . ~T <br />lS o v.2 ~~J~~r'io,~tJ ro o.°E~//Tc~ 77~~s <br />~/ T /~ s s vv,t) .']-s - 't'J<IiP_/« Go~l~ i r o.cJS' <br />~c~2 Mi T <br />(Rev. 02/87) <br />5257E <br /> <br />Signature (/~G~ ~~~.5/~E~r~ <br />