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- ~~~ ~ <br />~ iii iiiiiiiiiiiiiiii <br />111/112 Enclosure <br />Permittee Name: Broderick & Gibbons ~~ ~ ~~~ ~~ <br />~~ <br />Permit No: M-81-307 <br />Operation Name: Fountain Pit p ~ ~ 1 ~ 1986 <br />Anniversary Date: 12 / 03 / 86 <br /> MINED LAND <br /> RECLAMATION DIVISION <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 Land Reclamation <br />Division for annual fees due <br />X Annual Report <br />_ Map <br />Signa <br />Ui <br />~-~~~ <br />~e <br />_~ <br />