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<br /> ~" 'ED LAND RECLAMATION DIVISION NO OO7OZ5 <br /> 1313 Sherman, Room 423 _ ~,l _ ~ -~ / y <br />Denver, Colorado 80203 DATE ~L~sU 7 <br /> (303) 866-35 <br /> ~ <br /> ~L /~ <br />RECEIVED FROM _ ~CS~e ` <br /> S <br />~. ~~~' <br />m DOLLAR <br />THE S <br />U <br />M <br />OF <br />S <br />$ ~ <br />J <br />~ <br />~ <br /> (~~ <br />~ <br />//y/~ <br />p~) q <br />)/ <br />+ <br />\ <br />~ <br />~ <br />/ <br />_ <br />FOR 1~ ~i'~ ~/ I - ~ ~~ ILA VJ CY7 O Q O cK <br /> AMOUNT OF ACCOUNT...... $ ~~ I^ /~ Iou~ <br />l ` <br />1 <br />~ <br /> ` <br />,J <br />AMOUNT PAID ................ $ I~ <br /> BALANCE DUE ............... $ BY <br /> <br />