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iii iiiiiiiiiiiiiiii <br /> <br /> MINED LAND RECLAMATION'DIVISION N~ 19257 <br /> 1313 Sherman, Rm. 215 -~ ~ ~ p <br />Denver, Colorado 80]03 DATE ~ ' ~~'~ t g / Z <br /> RECEIVED ^7 /x(303) 8(66.3567 ~` -~yA ~~, /'~ <br />~-XX/• <br />L <br />/~ <br />I ~ <br />$ <br />FR <br />O <br />1' <br />I. <br />I <br />i <br />YI <br />Q <br />~{ <br />J <br />7l~X~ <br />- <br />M <br /> ~ <br />I~ <br />I{ <br />-(~~ <br />// <br />~,~,, •~, <br />~ <br />` <br />- _ <br />^ <br />) <br />-/ <br />~ ', <br />Ldl`I~ U~,~~[ I ~ <br />~,, (/~/ ~1c <br />~ <br />~ <br />\11A1i1[/`l'.P~ ~F" ~V~~T-RIVTARS <br /> I <br />__ <br />II <br /> ^ CASH <br />UVV <br />~y <br />~ J r~ Q '~ <br />7r <br />• <br />~~ <br />~-9~ <br />~iy <br />ly~o <br />~ <br />p H <br /> N <br />o <br />J <br />P <br />1/ r <br />i l-l~C <br />FOR <br />- <br />0 <br /> . <br /> AMOUNT OF ACCOUNT. .. ... ..$ P <br />/~' <br />I <br />A <br />~. <br />' <br /> 2 <br />O <br />• <br />\ <br />J <br />AMOUNT PAID . .. .............$ <br /> BALANCE DUE ... .. .. ......$ BY <br /> <br />~ 0 ~ <br />M-Y(~Wr P bbb 579 3b8 <br /> <br />O <br />U <br />m <br />m <br />0 <br />ui <br />r <br />N <br />C <br />CFA <br />O <br />T <br />.~ ~ <br />~ ~ <br />r ~ <br />l7 O <br />r O <br />M <br />.J E <br />C IL <br />c rrJ <br />a <br />Certified Mail Receipt <br />No Insurance Coverage Pr id <br />~~ Do not use for Internatlonal~rtl <br />5 ;; (See Reverse) <br />Sem to pelf cltW R• ?.a <br />li~c <br />Street 8 No. <br />P. o, t $ f 7 <br />PO. Stele 8 ZIP Cotle <br /> 8! Y27 <br />Postage G /,~ <br />CeNLatl Fee ,. <br />-/ <br />Spacial Oelrve , <br />,~_ ~r <br />ResUigetl Delwe ~ / <br />Return Rxaipl Showing <br />to Whom b Dale Deliveretl <br />Return Receipt Showing to Whom, <br />Date, b AOaress W Delivery <br />IpTAL Posmge <br />~ <br />8 Fees . <br />Postmark Or Dete <br />