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KIOWA COUNTY OUT OF MONEYS IN THE TREASURY BELONGING CHECK NO. /1 00407 <br /> BOARD OF COUNTY COMMISSIONERS TO TREASURER OF KIOWA COUNTY Dv� <br /> P.O.BOX 100/EADS,CO 81036 83-1284/1011 <br /> PHONE (719)438-5810 FAX(719)438-5615 ` RB 100407 <br /> VOID AFTER 60 DAYS Permit# �ZOZ!0�J <br /> Receipt#3 3 3r 7�/ <br /> PAY Two thousand six hundred ninety-six dollars and no cents <br /> DATE AMOUNT <br /> (W28/2021 $2,696.00 <br /> TO THE COLORADO DIVISION OF RECLAMATION <br /> ORDER MINING & SAFETY <br /> OF 1313 SHERMAN ST., ROOM 215 <br /> DENVER, CO 80203 0 <br /> United States <br /> AUTHORIZED SIGNATURE 9°es <br />