2020-07-16_REPORT - M1985001

• Permit No: M1985001
• IBM Index Class Name: Report
• Doc Date: 7/16/2020
• Doc Name Note: Annual Fee
• Doc Name: Receipt of Payment
• From: Glacier Gravel Products
• To: DRMS
• Email Name: LJW
• Email Name: AWA
• Media Type: D
• Archive: No

Customer: JIM AND SHARON HELMERICKS TBK-ir- BANKJ �o 414337
Branch: 4235 12700 Park Central Dr.Suite 1700 Dallas,TX 75251 ,SD'
Prepares SNV MS PH:866-644-3935 DATE 07/10/2020
PAY TO
OF $ 348.00
ORDER THE COLORADO DIVISION OF RECLAMATION & MINING SAFETY
_- DOLLARS
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YEARLY ANNUAL REPORT 1985-01 �
CA�SEIER'S CHECK �e�'p# � /77� /VOID AFTER 6MONTHS
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JUL 3 2020
DWION OF RECLAMATION
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