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.~ <br /> <br />110 and 111 Enclosure <br />Permittee Name: Charles W Houchin <br />Permit No: M-80-249- <br />Operation Name: HOUCHIN GRAVEL PIT <br />Anniversary Date: 02 / 04 / 86 <br /> <br />FEB 1 ~~ 7986 <br />~i ^ n r.•^..- <br />Please complete the following and return this form with your feesu~ri8d5~•~• ~~t~~'•.,.;`~;,,~ <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 />lc Annual Report <br />-, <br />ii <br />Signature <br />~~ <br />f <br />