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~ MINED LAND RECLAMATION DIVISIC <br />' 1313 Sherman Street Room 423 <br />Denver, CO 80203 <br />(303) 8663567 <br />RECEIVED FRpM C <br />THE SUM OF ~{ 4 <br />FOR_ "0- <br />AMOUNT OF AC UNT...... $ <br />AMOUNT RAID ............... $ <br />EIALANCE DUE ............... $ <br />I ~. _ <br />, PLEASE DETACH THIS REMITTANCE BEFORE DEPOSITINGrCH ECK <br />I. <br />r x x•SeleFmn uuu m~evien x~xx.s le i r <br />Yo Yr~iLre~[e ~ PAYEE NANE <br /> Mi L e ti <br />JW <br />Se r i ] e]e i nn u]3 len <br />L INVOIEF I•rY[Yl CN[G <br />I o•n <br />i o•re •YOUEIr <br /> <br /> <br />O Y Y O O] Y Y Y D O <br />~ 1~t ' ~ 01.h.. y .. <br />PAYMENT TO THE ACCOUNT OF <br />EAG.L E.WEST CONSTRUCTORS <br />P.O. BOX 900 EAGLE, COLORADO <br />REQUESTED 8Ye <br />DATE PREPAREDS i / 12/ E4 <br />YD. DAY Y0. <br />N °_ 12 0 2~(/~- <br />GATE ~~ ~ 1 L <br />fl E+-I <br />HECK <br />fr ~r\ /~~ ^IVto <br />l ~YIQII~~ ~U I / ~~ • <br />N° <br />I <br />? : •• <br />,. <br />y; ~ <br />sw `' <br />38 J9 0 1 2 s 1 <br /> <br />CHECK IYYOICI <br />Ywe[e <br />MUYBER <br />005.67 nii <br /> •ccoLwr oo]e~wrloY COe[ olerA~eYrioY AYWM <br />c <br />' +oe coer n[n oFYie.L <br />E <br />c MVY[f[ ITEM YO L[pOQ <br />Y o <br />O mL•x.r .[ouwwr Yux] .ccr Yo, <br />t MWeE11 (AO[ 00[ <br />333[51 3p 39 W N el Y lO lr xIJL A]l TreR 1 <br />2 _ _ _ _ _ 5 <br />J - - (] <br /> <br /> <br />s <br />6 <br />~ '~ <br />• <br />r.~B~~® <br />51984 <br />tt11NED LAND RECLAMATION DIVISIOPI <br />Colo. Dept. of Natural Resources <br />