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<br />Permittee Name: Duckels Construction' INc'•
<br />Permit No: M-76-051 Q q G 0
<br />Operation Name: Bettger Gravel Pit ~•a~
<br />Anniversary Date: 05/08/90
<br />Total: E.00 (Due on the Anniversary Date)
<br />Please return this form with your completed Annual Report, map, and a
<br />check or money order for annual fees due, payable to the Colorado Mined Land
<br />Reclamation Division, 1313 Sherman Street, Room 215, Denver, Colorado 80203.
<br />ANNUAL REPORT:
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<br />Signature
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