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<br />~~~~j~s/~® 110 Enclosure <br />Permittee Name: pueblo Paving Co F EB 2 Gl19ea7 <br />Permit No: M-80-246 <br />Operation Name: Zellitti Pit M1NE~ AND <br />Anniversary Date: 02/28/87 (iEC1AMATlONp1VIS~ON <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 /> <br />Signature <br />a/~6r~~ <br />~ ~. ~~ <br />C cr~~~n csd5 $ <br />~} ~ n !'G7" ~/f <br />~- - .. <br />