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111 IIIIIIIIIIIIIlII <br /> <br /> MINED L. ~ RECLAMATION DIVISION N ~ <br />14958 <br /> _ <br />13r3 Sherman, Rm. 215 - ~j ~ <br />Denver, Colorado 80203 DATE ~ " Z 2 19____L <br />(303) 866-3567 /~ <br />RECEIVED $ 3S <br /> U~ <br />FROM <br /> - `~ D <br /> <br /> ~/J /~ C l,' ^ CASH <br />FO Y17 ~'/~7%'~/~ ~~YJ~CK <br /> <br /> AMOUNT OF CCOUNT...... ....$ n' ^ <br />I <br />~~ <br /> IK <br />AMOUNT PAID ..... .............$ <br /> BALANCE OUE ... ...... ..... .$ 8Y <br /> <br />