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<br />• iiiiiiiiiiiiiiuiii • <br />999 <br /> <br /> MINEii LAND RECLAMATION DIVISION N~ 0 0 4 0 5 2 <br /> 13i3 Sherman Street Room 423 <br /> ~ i' <br />Denver, CO 80203 DATE ~ ~' 19 ~I <br />] <br /> . <br />(30j) 66-3567 <br /> ~ //~~ <br />RECENED FRDM I~`I:~~,. C~~` `_~'~~-.: C,YL._ Cc' <br />' <br /> ~ ~.:. <br />~ <br />C( <br />i'C /1i: <br />L " <br />L ` <br />' <br />~ <br />S ~/ '~ ~ <br /> ~ <br />, <br />L <br />THE SUM OF C: <br />- <br />. <br />~ <br />DOLLARS $ / <br /> 7~"~ 7~j-l~~ i ~CnS-~ <br /> r- <br />FOR ~-~~1,7 FL [. .~ 75' -/C 7S-/~1 ~7S-/~~ ~(,~C~ ).~ ~ ~.ecK <br />HMO <br /> <br /> AMOUNT OF ACCOUNT...... $ I^ 1,~ <br />Q <br />~ <br />~UI <br /> VI <br />Y` <br />11 <br />AMOUNT PAID ................ $ ~ ~~l/ <br /> Y r <br /> BALANCE DUE .... ...... .. 3 BY -, - Ci_C' ~ ~' ~L <br /> <br />