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<br /> <br />~- <br />. ' ~ ~ ~II III~I~II~~~~~~II <br />112 Attachment <br />Permittee Name: Braley Sand and Gravel /Q ? <br />``V ~o <br />Operation Name: ,PALE// SAAJd AAIo~ ~,P~9UEG,~c. ` o~Q p~\~o~ <br />Permit No: 80-20 ~~~ 'ti^~ ~~'~~~~~J <br />~ S `~~ <br />Anniversary Date: July 15 ~ ~J Quo ~v <br />~?~Q~"° <br />Operator: ~~'~vo~ <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />.~' Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />I_I Annual Report <br />I_I Map <br /> <br />