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<br />Permittee Name: Holyoke Gun ClubY <br />Permit No: M_77_075 <br />Operation Name: Holyoke Gun Club Pit <br />Anniversary Date: pg/P7/87 <br />Please complete the following and return this form with your fees and <br />reclamation data. <br /> <br />Enclosed are: (Check space(s) below) <br />_;~_ Check or_money.order payable to Colorado Mine.d_Land Reclamation <br />'~ Division for annual fees due <br />J Annual Report <br /> <br />110 Enclosure <br />-, a .~.~ <br />S~.P 3 01987 <br />~r <br />Signature <br />(Rev. 02/87) <br />5257E <br /> <br />9~' <br />Remarks: ~~v ~~~'~ ~~.~ ~_~~ ~~~ <br />