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<br /> <br />_:_.~ - <br /> MINED LAND RECLAMAT~ DIVISI' N 0 ~ 1 ~ 2 7 C <br />1313 Sherman ~ <br />~/ <br /> _ <br />Denver, Colorado 80103 _ - DATE ~O ~ ~ a ~B~_ <br />(303) 8663567 $ <br />RECEIVED <br />FROM <br />-~ • ~Q n ...... ~~[q ~ /i ~' ~ <br /> <br /> y <br />S . l ~-. ~ ~ 00/~ 00 DOLLARS <br /> 1 <br /> p <br />,~y~ D~(CHECK <br />~2-c <br />/ / 1' Sc~-C~~O SSn~oR ^ M.O <br />FOR ~,y~o.o~ <br />._ <br /> . <br />o- <br />/ <br />- <br /> 1 <br />AMOUNT OF ACCOUM. ........$ <br />I <br /> AMDUM PAID .......... .. ......$ ~ •'QIl1C OlA <br /> BALANCE DUE .......... .........$ BY - ,/ ~i ~ . iu p~ <br /> <br /> <br /> <br /> MIN[ VD RECLAMATION DIVISION <br /> ~"~.-:3 Sherman, Room 215 ~--~/ <br /> Denver, Colorado 80103 - <br />b <br />- <br />~ <br /> DATE <br />~ 9 <br />(303) 866-3567 ~ <br /> $ <br />SO <br />M <br />OM ~ <br />F <br /> . <br />. GY <br />r.~ a~'~ <br />R <br /> <br /> "} DO <br /> <br /> n/,, ,, ^ CASH <br />FDR ~li'i~~ )iXIJ ,j-~ -xa-afl ~s95''~'o K <br /> <br /> AMOUNT OF OUNT...........$ <br />[7°I I <br />~ <br /> /\ <br />j- <br />J,. Q O <br />;`%~/ <br />J <br />AMOUNT PAID ...................$ C <br /> ~ <br />~, <br />, <br />J <br />BALANCE DUE ........ ..........$ BY <br /> <br />