Laserfiche WebLink
iii iiiiiiiiiiiu iii <br /> <br /> MINED I"ID RECLAMATION DIVISION ~`~~ 19625 <br />J Sherman, Rm. 21~ _ <br />Denver, Colorado 80205 '- ~ '~ C,`~~ <br />DATE S' ~y <br />19~Lc <br />03) 866-3 <br />567 <br />(3 <br /> fU\ <br />~/J ~ <br />EO <br />~ <br />7 <br />~ <br />~ <br />$ ~ <br />1 <br />F <br /> ~ <br />Ll <br />(1,C1 N I/Illl IAJ-"J ~ <br />Of'.!//IR~T <br />C/ • <br />ROM <br /> ~~-~ l~`~~ D~~~~ ,~ ~ ~r~ ~ AH$ <br /> <br /> ^ CASH <br />~/ ~ HECK <br />Eoa l2~'ir~ po /~ /' 6 'J.~ ~i~~/~ o r D. <br /> AMOUNT 0 CCOUNT ......... $ <br />I <br />~ <br />~ <br /> OU <br />Q ~ <br />AMOUNT PAID ... ......... ....$ <br /> BALANCE DUE.. ...... .....$ BY ~ ~ <br /> <br />