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REc`I V ED 112: Enclosure <br /> Permittee Name: Cooley Gravel Co AUG 2 0 1%5 <br /> Permit No: M-76-009-SG MINED LgND <br /> Operation Name: MENZER QUARRY RECLAMATION DIVISION <br /> � Anniversary Date: 06 / 23 / 85 <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 /> _ x Annual Report <br /> x _ Map <br /> Remarks: The annual fee was submitted under separate cover . <br /> A copy of the check is included in this report as a record <br /> of payment for varification . <br /> 47 <br /> Signature <br />