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III IIIIIIIIIIIIIIII <br /> <br /> DIVISION OF MINERALS AND GEOLOGY N~ 24061 <br /> . _ DATE 7 <br />9~ <br /> RECEIVED $ <br />~ <br /> ~-~-' r~r LI <br />FROM ~ <br /> CC~~ <br /> SC..J ~r / RS <br /> ^ CASH <br /> l /yJ Gy <br />p ipCK <br />~ ~ ~ <br /> ~~ol ~ <br />FOR `~ ~ % /~l ~ / <br /> <br /> AMOUNT OF A COUNT...........$ 11 <br />~ ~~ <br />l <br /> AMOUNT PAID..... .....~ .....$ <br />u <br /> BALANCE OUE ...................$ BY <br /> <br />