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MINE'' 'AND RECUMATION DIVISI0~1 I D 1614 4 <br /> ," ~ 313 Sherman, Rm. 215 `- / <br />Denver, Colorado 80703 - <br />~ <br />~ <br /> DATE ~ <br />__ 19 <br />/ <br />(303) 866-3567 <br /> RECEIVED $ <br />~ <br /> <br />FRO <br />L <br />-~1LJ <br />~ <br /> - <br />DOLLARS <br /> <br /> ~/y/ CC -1 ^ CASH <br />FDR~ P /~ (~ O~' ~~ o'~~ b`CI~ECK <br /> <br /> AMOUNT OF UNT..... .. ..$ IA~ <br />! <br /> ou <br />AMOUNT PAID . .. ........... ..$ rl <br /> BALANCE DUE .......... ........$ BV <br /> <br />