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<br />-- <br />111/112 Enclosure <br />Permittee Name: Brannan Sand & Gravel Co <br />Permit No: M-80-183 <br />Operation Name: Pit 29 <br />Anniversary Date: O1 / 08 / 87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(sl belowl <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 />%o H2r~r%/~~/ Zo " <br />Signature <br />//~~r/t /i~i++~ /HC ~6.5/ /~Grt ~~ dG ~ /O ~~/ ~ ~1C $ / ~// ~~i <br />