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REP05175
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REP05175
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Entry Properties
Last modified
8/24/2016 11:36:10 PM
Creation date
11/26/2007 11:00:04 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1984013
IBM Index Class Name
Report
Doc Date
5/1/1985
Doc Name
110 AND 111 ENCLOSURE
Permit Index Doc Type
ANNUAL FEE / REPORT
Media Type
D
Archive
No
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P A Y E E DETACH THIS STATEME~'T BEFORE DEPOSITING <br />DATE ACCOUNT OR DESCRIPTION <br />INVOICE NO <br />5/14/85 <br />EM PLOYEE~S <br />NAME <br />M-84-013 PERMIT RENEWAL <br />Elk Creek Gold Mines Co. <br />AMOUNT OI SCOUNT OR NET AMOUNT <br />DEDUCTION <br />50.00 <br />N1 ~Y 1- ~ +3~ ~/ <br />- " - • • ~ QI~'j$;0, Elk Creek Gold Mines Co. <br />PAY PERIOD HOURS RATE GRO55 ~ ' <br />NET <br />ENDING EP RNING$ rco wnN sr4TC w <br />Ir EA R <br />NIOGS <br /> F ~ ~ ~ T/~X i1M PA <br /> ~ _, <br /> REG T ~ <br /> D T __ _ 1 _ I ~ __ I <br />EMPLOYEE: THIS IS A STATEMENT OF YOUR EARNINGS ANO DEDUCTIONS FOR PERIOD INOIC4TED. KEEP THIS FOR YOUR PERMANENT RECORD <br />MINED LAND RECLAMATION DIVI?"V N ~ 3575 <br />1313 Sherman Street Room 423 <br />Denver, CO 80203 /~~ <br />3RRR3 86(/-3JS67y, f f~/ GATE L~J/ /~ ~B~ <br />RECEIVED FROM ~/1 /~\//~~/17L C 7~ ~_~~/n f-~-~ ~, <br />THE SUM OF / /TV /7~ KJ ~/~~ DOLLARS $ ~O'2 <br />n / <br />FOR ~~J' / ~ P / ~ ~ ~Y Q13 pQo-IECK <br />MO <br />AMOUNT pF ACCOUNT...... $ ~I ^x~ ~ou~ <br />AMOUNT PAID .......... . ..... $ HU1l(j / y~ <br />BALANCE DUE ............... $ BY~) / /~ /-/I~ <br />
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