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999 <br />112 Attachment <br />Permittee Name: Greeley Excavation Co. <br />~ Operation Name: <br />Permit No: 77-151 <br />Anniversary Date: January 30 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check box(es)) <br />~=~' Check or money order payable to Colorado Mined Land <br />Reclamation Division for annual fees due <br />I~yl Annual Report <br />I x I Map <br />Remarks: mr,P existin4 25 acres in chase II were worked in 1908 and 198A. Th[rP <br />was no additional land disturbed in this period. No land reclaimed in the <br />period. <br />~gnature <br />(Rev. 5/84) <br />Doc. No. 1805 <br />