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• <br />• iii ~i-~i-~ii~~iui~ <br />112 Enclosure <br />Permittee Name: <br />Permit No: <br />Operation Name: <br />Anniversary Date: <br />Mountain Aggregates <br />M-77-534- <br />EMPIRE PIT <br />O1 /30!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 />X Check or money order payable to Colorado Mined <br />Land Reclamation Division for annual fees due <br />- Annual Report <br />Map <br />Remarks: The ennual report and map should be sent within the nexr '~~ Aa vc_ <br />