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~ ~ III IIIIIIIIIIIII III <br />• . , ~ 999 <br />110 Enclosure <br />Permittee Name: Walsenburg Sand 8 Gravel, Inc. <br />Permit No: M-78-283 <br />Operation Name: Sand Arroyo <br />Anniversary Date: 04/24/88 <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 />Remarks <br />~:: . <br />I <br />Signature <br />7331 G <br />0052f <br />