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• • iii iiiiiiiiiiiuiii <br />,- sss <br />110 Enclosure <br />RECEIVED <br />Permittee Name: <br />Permit No: Moffat Limestone Company S~ p 1 0 1981 <br />Operation Name: M-82-141 <br />Anniversary Date: 0B~09~87Quarry ~K MINED LAND <br />RECLAMATION DIVISION <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: <br />~~ T~G Drr euT ... <br />/ix~Sfstit ~CQ•r~r• / -} <br />~' ~~ /Ce~[r..a ~/rK W~/~ ~+[l Qi/~t ~/a/iK; ~~iJ /[ rrl <br />DLL/~sl . <br />i ri a i fi v t r~.... i r ~ ~L. ~ e. i.~ ~ - ~ _ B L f. 8 - ~ - B 9 , <br />~iyiia ~u~c ~ J~IA L.t~wt~YC~+1~-f <br />(Rev. 02/87) ~f <br />5257E <br />