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• iii iiiiiiiiiiiii iii • <br />999 <br />` ;. 111/112 Encloas~ <br />Permittee Name: Broderick & Gibbons <br />Permit No: M-81-307 Gtr 1 ~' i9c8 <br />Operation Name: Fountain Pit <br />Anniversary Date: 12/03/88 ~~;;:~~-s`i'"'~~~ <br />litGLi~iv'P.I fC~~ v~'~~~;~.)cv <br />Please complete the following and return this form with your fees and <br />reclamation data. <br />Enclosed are: (Check space(s) below) <br />Check or money order pdyable to Colorado Mined Land Reclamation <br />Division for annual fees due <br />~_ Annual Report <br />Map <br />Sr <br />Signature <br />(06/88) <br />0054f <br />