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• <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date <br />~ ~. <br />Andesite Rock Company <br />td-77-141 <br />Lyons Quarry <br />12/29/88 <br />., iiiiiiiiiiiiiiiiiii <br />111/112 Enclosure <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 />~+lap <br />Signature <br />(06/88) ~c;:' .. .,. _'.v ' ? . <br />0054f <br />