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• <br />112 Enclosure <br />Permittee Name: Richard E White <br />Permit No: M-81-006- <br />Operation Name: West Rifle Pit <br />Anniversary Date: 04 / 27 / 85 <br />Af rz2 «195 <br />Please complete the following and return this form with your (fees and 1,.,; ~ <br />reclamation data. -~ ~~~ ,,, ,g <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 />ignature <br />