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iiiiiiiiiiiiiiiiir .~ <br />~~~5 <br />112 Enclosure <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />Albert Frei & Sons <br />77-153 <br />RECLAMATION PIT N0. 1 <br />February 6 <br />. ~. <br />~, , ~ Lei <br />aP^ - s 1985 <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 <br />Map <br />Remarks: <br />Signature <br />