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iii ii iiu iii <br /> <br /> <br /> ' MI, ~ LAND RECLAMATION DIVISION N ~ 1518 5 <br /> `" 1313 Sherman, Rm. 215 ~ <br /> Denver, Colorado SOA3 - DATE ~ ~ 19~ <br /> (303) 866-3567 <br /> RECEIVED ./ -+ tn~ n , $ <br /> P~i-~ii <br />v, fin[. ~• ~'~ <br />FROM l.Y _.~~rv~.C~s,A /~~29 ~ <br />/C <br /> / <br />/ <br />~ <br />"~ <br />~ <br />~ <br />~U <br /> r~ti~~ <br />~ .~ <br />~/ w <br />//GY> <br />D <br />LARS <br />OL <br /> <br /> ~ <br />, <br />~ <br />ECK <br />" <br /> ' ~^ <br />-~~~- Qd- 0~3 ~~ /1~~[,~ ~ <br />FOR I}iYl/I7 1 <br /> ~ <br /> AMOUNT OF ACCOUNT ...... ...$ r,~ <br />Q <br />~ <br />I <br /> YI <br />QU <br />AMOUNT PAID ...... ............$ <br /> BALANCE DUE . ...... ....... ..$ B1'"" ~iLU.im w. -.ny <br /> <br />