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III IIIIIII 9 IIIIIIIII <br /> 99 <br /> M <br /> DIVISION OF MINERALS AND GEOLOGY N° / 26466 <br /> DATE <br /> RECENED <br /> FROM 1-2 <br /> d— <br /> ❑CASH <br /> wrr <br /> ND� q3 117� 118 FS� 22 YBri�o Mo <br /> AMOUNT OF ACCOUNT...........$ UI <br /> AMOUNT PAID...................$ ( 1� <br /> .` BALANCE DUE...................$ BY - <br /> THE FACE <br /> OF DOCUMENT HAS A COLORED -• • ON WHITE PAPER <br /> s S01[ERS$T'1[�NINGC01[)E <br /> 0004893 <br /> �)o ils�ow�oi Pora <br /> ,.. (io <br /> Ve,t Patui Seactg FL=33401; ,,=:y DATE <br /> t- <br /> ': � ec: I <br /> . 1 <br /> ;One; Thousand Nie"Hiiri ed and00/100 <br /> DOId:ARS. .;;: <br /> ., void After 90 VM <br /> PAY _ ;STATE <br /> OF: COLORADO <br /> ,o ne 7DIVASIbN OF,$ NERAI S <br /> nim�x 1313 SHERMANST ROOMs,2 a <br /> �P DENVER;�:CO`", A': 80203.. <br /> .. .... .. .. ^�VOI�$5,OOp:OO" <br /> 22-: :11'00000000 k8 R 3n8 1:0.13 3 90ASS01:0,30.9 5.5j.3.7 6 9u' <br /> :'.M L: ,-93-�Ii7t118:..`' <br />