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<br />r`r`' Permit mo: 77-436 <br />Anniversary Date: August 23 <br />Operator: <br />+~ iii iiiiiiiuiiuiii <br />999 <br />Please complete the following and return this form with your fees and reclama- <br />tion data. <br />Enclosed are: (ChecY, bc:r(esJ) <br />Check or money order pauable to Colorado Mired Lard Reclama- <br />ti on Division for annual fees due <br />Annual Report <br />Map <br />Remarks The Annual Report and Map will be prepared by Rindahl and <br />Associates. They will forward directly to you when completed. I have <br />advised them of the information not provided in last year's report, and <br />it will be included in this year's. <br />Signed, READY MIXED CONCRETE COMPANY <br /> <br />