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<br /> <br />112 Enclosure <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Cooley Gravel Company <br />M-76-009-HR <br />MENZER QUARRY <br />06/23/86 <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 />~~~~1poo~, , ~ <br />gnature <br />