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1 <br /> <br /> MINED LAND RECLAMATION DIVISION N~ O O 9 2 O O <br /> 1313 Sherman <br /> Denver, Coloredo 80203 ~ DATE fad 19~ <br /> _ <br />(303) 8663567 <br />RECEIVED $ <br />57' <br />" C <br />n57(Uo ti`a~ ~ a ur~~ Oa <br />J' i <br />a <br />FRO <br />M <br />-15 ice <br /> [ <br />/ <br />x <br />~ <br />/ ~ ~ <br />~ <br />/ <br />~ ~ <br />Jl!/ . AL1!/l~fcr/ .ALL/~ ~~~~0 DOLLARS <br /> <br /> /~ <br />~jlf /o~ ~~ ~ ~'•Qr~~b/~ ~ QECK <br />FOR <br /> ~ <br /> AMOUNT Of ACCOUM...........$ (`~~p /~ fj~ <br />~ <br />! <br /> u~l~ ~~ <br />AMOUNT PAID ........ ...........$ V <br /> BALANCE DUE ............ ..... $ 9Y <br /> <br />