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2023-08-28_REPORT - M2021058
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2023-08-28_REPORT - M2021058
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Last modified
8/28/2023 4:14:21 PM
Creation date
8/28/2023 4:08:53 PM
Metadata
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Template:
DRMS Permit Index
Permit No
M2021058
IBM Index Class Name
Report
Doc Date
8/28/2023
Doc Name
Receipt of Payment
From
CJK Milling Company LLC
To
DRMS
Annual Report Year
2022
Email Name
LJW
THM
AWA
Media Type
D
Archive
No
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-a VTEM&K <br /> I A W COLFAX AVE. <br /> <br /> tALAKEWOOD CO 80215 <br /> REIINT-TER <br /> :SW1 964.3444 <br /> UNION M1LLIN0 CONTRACTORS <br /> - pATE Auglfst 28,2023 � <br /> PAY TO THE DIVISION OF RECLAMATION MINING B SAFETY <br /> ORDER OF e <br /> 1F a $816.00 <br /> MArrc�rt eIM. srx rruw xcw trio $ <br /> �f5 dor¢�,rnl�irl Q[dt¢Nb 6R[k9MMR�.'Oi(i3O�opm m.�nwv�,¢�e W[kJtd�oufk�rtlx'WN�fIMRN;d�i/':�.''✓�.f �g <br /> � + k <br /> jgRW TJ�1�;�AL a cry. <br /> CASHIER'S CHECKa,e <br /> Notice to Customer:If OAS Cheek is lost,stolen or desboyed within 90 days a1 the _ <br /> dale it is 3aued,we will not pay or ran&*a replacement cheat wdhdul an <br /> ndemnity bond or 91her adequate security.After 90 days,we will pay or relss <br /> reptscement crack upon racelpi of u properly executed dsclarshon d loss form. <br /> AUT114CIR12EDSIGNATURE <br /> <br /> si IW3W COLFAX AVE. <br /> <br /> {m-964-3444 <br /> REMITTER <br /> UNION MILLING CONTRACTORS DATE August 28.2023 <br /> PAYABLE TO DIVISION OF RECLAMATION MINING 6 SAFETY <br /> Akrourrr <br /> A PYW AL. P642.r.rr $816.0 0 <br /> M ?'-)Z1 - o'5 g <br /> CASHIER'S CHECK RECEIPT <br /> Not,ce to Customer:If this nheca is lost,stolen,or deslraysd wMih 90 days of the <br /> date it is rssuetl,we wA rwt pay or reissue a rapiacomant check without an NOT NEGOTIABLE <br /> Intl emnky bond or dollar adequale aecunty After 90 drA.we will pay Or rensua a <br /> replacement check upon recta of a property executed declaration of lass form. <br />
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