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<br /> MI. ~ LAND RECLAMATION DIVISION N~ 2 3 7 2 3 <br /> 1313 Sherman, Rm. 215 - <br /> <br />Denver, Colorado 80203 <br />(303) 866-3567 ~y <br />pATE ~ ' /S 19 <br /> RECEIVED C - <br />~ $ <br />~ <br /> FROM ~-~-Q)lA.(1 .~.~ <br />Qh~ <br /> <br /> <br /> ~- ~ DO <br /> <br /> ^C H <br /> FD Qi)M ~~ -oZ <br />^ M CK <br />. <br /> . <br /> AMOUNT DF ACCOUNT......... .$ l <br />A <br />~ `l <br />` <br />~ <br /> <br />AMOUNT <br />PAID .......... .......$ 0 <br />J <br />` <br />I~ <br />II <br />lFrl <br /> BALANCE DUE ............ ... ..$ BY <br /> <br />