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<br /> <br />'110 and 111 Enclosure <br />,I~il, ' i~ 1500 <br />Permittee Name: L Otto Goemmer <br />Permit No: M-82-729- <br />Operation Name: Goemmer Pit. <br />Anniversary Date: OS / 05 / 86 -~ <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 />Remarks: ~A/.,~, ~_ `7Z~--f/ 7t~t~~ <br />~1ize~-v~-~~ ,i.ti~r ~ 1i i <br /> <br />