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<br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br /> <br />111/112 Enclosure <br />Ready Mix Corp. <br />M-77-436 <br />Rec Project No 1 <br />08/28/88 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />X Check or money order pdyable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />X Annual Report <br />X Map <br />Remarks: <br />~u ~ ti ~ ~9a <br />taF(:LAlJlA71(71~i U+'/'`~I~IbJ <br />5 nature Mr. ames Sweetman, Vice President <br />Ready Mixed Concrete Company <br />(06/88 ) <br />0054f <br />