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<br /> MINED LAND RECLAMATION DIVISION N~ 0 0 8 5 9 0 <br /> 1313 Sherman p. <br />Dower, Colorado 80203 DATE ~ ' ,z 7 ~9~ <br /> {303) 866-356M7 <br />RECEIVED ~Q.l) l ~ y /' ~ c -~ $ <br />FROM I ` c•Lf' <br /> <br /> `{-C-x .1_~ Lr~ DDLi_ARS <br />U 1 <br /> ' /~f ~ a- 5 g ~GNECK <br />- <br />~ ~S <br />Q <br /> ^ M.O. <br />G /~ ( <br />FOR~ <br /> i <br />' <br /> AMOUNT OF ACC <br />jlVT...........$ I,~ff^^ <br />dl <br />Q~ <br />Q <br /> . <br />IIIG <br />AMOUNT PAID ................. .$ <br /> BALANCE DUE .... ..............$ BY <br /> <br />