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<br /> MINED LAN' RECLAMATION DIVISION N O 2 2 9 5 7 <br /> 131 b~nerman, Rm. 215 _ ~yi ~ ~ <br />D <br />enver, Colorado 80203 - ~ DATE ,~ ;~ 3 t 9 ~-~ <br /> 5 <br />~30 Sn3~67~~ <br />/~ <br />~ <br />R <br />ED <br />,1 <br />/ <br /> 7 <br />OM <br />VV/ <br />U <br />` <br /> ~~ <br /> ~ / DOLIARS <br /> ~JJ// // ~7 /` ~G EH~CI( <br />FOR~1?/~ N.~ /~ ~ d''~ ~ I JO SJ ^ M.O. <br /> <br /> AMOUNT OF CCOUNT.. ........$ I ~ ~U! <br /> AMOUNT PAID . .......... ... ..$ <br /> BALANCE DUE . ...... ... ......$ BY <br /> <br />