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<br />MINED LAND RECLAMATION DIVISION <br />1313 Sherman, Rm. 215 <br />Denver, Colorado 80203 <br />(303) 8 3567 <br />RECEIVED/1 ~Im ~,~n~/~,~o~ <br />FROM `1Lll~ u,W~. {~ <br />X43-Ia->a~9~ Iv9+70 - C 8 <br />FORS 4~ 34->`lt K3 `/9+58-~1.3 <br />N°_ 18368q6--~~,, <br />GATE ~ _ a~ 19~ <br />DOLLARS <br />AMOUNT OF ACCOUM ..........$ ~ OU <br />AMOUNT PAID ............. .. ..$ <br />. ........-S <br />BALANCE DUE.. ,... BY <br /> TFIE FlRST NATIONAL BANK <br /> <br />BASIN RESOURCES, INC, IN TRINIDAD <br />TRINIDAD, CO eloex <br />14300 HWY. 12 ~ 82-13/1021 <br />WESTON, CO 81091 <br />-~ <br />PN. 719-989.2781 DS / 2D ~ 9 3 <br /> PATE <br />*THIRTY NINE THOUSAND NINE HUNDRED DOLLARS AND NO CENTS <br />PAY <br />TO THE Department of Minerals <br />ORDER and Geology <br />of 1353 Sherman Street, Room #2i5 <br />Denver CO 80203 <br />DEP MIN <br />II'00 7 7D 21I' 1: LO 2 300 i 381: <br />D9J 93-1»19, (o7..t..7(~..= Cr.SI-/3 <br />93-3Y~H1, y3. 4V-Sr-sv3 : C-81- I Z <br />007702 <br />007702 <br />****39,900.00* <br />AMOUNT <br />BASlN RESOURCES, INC. <br />2 SIGNATURES REGUI DOVER 525,000.00 <br />----~ 02 - <br />O4 ~$8 4u~ DESIGNATED REPRES ATRIES <br />