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T ~ • <br />111/112 Enclosure <br />Permittee Name: Robinson Brick Co <br />Permit No: M-77-252 <br />Operation Name: Pioneer Mine <br />Anniversary Date: O1 / 13 / 87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enciused 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 />Map <br />Remarks: <br />Signature <br />