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M iiiiiiiiiiiiiiuiii ~ <br />111/112 Enclosure <br />.- ~ ~ ~-:, <br />Permittee Name: Delta Sand & Gravel <br />Permit No: td-77-020 (.iAR 23 1989 <br />Operation Name: Pit No 1 _ <br />Anniversary Date: 03/23/89 ~~~ •-~~ ~-"~ -~% <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 />Map <br />Remarks: <br />Z i~~~ <br />Signature ~ <br />