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y <br /> <br /> MIN LAND RECLAMATION DIVISION ti ~ p •1 ~ y 3 <br />1 <br />~-' 1313 Sherman, Rm. 215- <br /> _ <br />qq ~~ <br />Denver, Colorado 80203 DATE S - 3 y 19_1_ <br />(303) 866-3567 <br />RECENEO ,(~ ~( /~ (~ ~ ~ Q / y~ ~ 7, ~ <br /> <br /> <br /> <br /> ^ GASH <br />FOR .YDV 1 ~ ' ~"~ ~ // / - G~` ~7 ( l~j ~~ ~ MHp K <br /> <br /> AMOUNT OF ACCOUNT ......... $ <br /> <br />Q p~ QU! <br />AMUUNT PAID . ........... ..... $ <br /> BALANCE CUE .............. .....$ BY <br /> <br />