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441 `- -11 lI <br />IIIIIII~~I~I~III III <br />Permittee Name: Horn Ranches Inc <br />Permit No: M-83-102- <br />Operation Name: Horn Gravel Pit <br /> <br />110 and 111 Enclosure <br /> <br />Anniversary Date: 08 / 02 / 86 S En 2 1886 <br />' . ,,,,.. <br />Please complete the following and return this form with your fees and ~~ "~ "~ <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />.C Check or money order payable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />Annual Report <br />ure <br />9 ~ ~! ~6 <br />~~ ~` <br />~,• (,~ <br />~_ <br />