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<br /> MINED LAND RECLAMATION DIVISION N 0 ~ 1116 2 <br /> 1313 Sherman, Room 215 ~., c~ <br />Denver, Colorado 80]03 DATE ~~-a3 ~9~ <br /> 866-3567 <br />RECENED (~ <br />~ $ <br /> ~ <br />FROM L-U Cwt-1 <br /> BO r <br /> ,1 <br />7CA A <br />~ i ~ uARS <br /> <br /> ~ / <br />HECK <br />wR~Qt/Yl1C QP Ct -77- a~ ~( /52 ^ rasH <br />I ^ .o. <br /> <br /> AMOUNT OF A COUNT...........$ <br />l <br />l <br /> ¢ ou <br />a. <br />AMOUNT PAID ...................$ <br /> BALANCE DUE ...................$ BY <br /> <br />~~ -..~ <br />- RECEIPT Dotet~? ~ 19 t1 <br />Received From KA-~-~ ~ c ~~-r~ <br />„~_ - _ <br />I 4~ <br />For <br />AMT. PAID <br />-~ cs- ic. cA 1 ^1 O~O Q- <br />..~ 4 -°~~ <br />MOW PAID , <br />USH ~'L <br />I~966 <br />_Dollars $ <br />MINED LAND RECLAMATION DIVIS ND 3783 <br />- '313 Sherman Street Room 423 ,J <br />Denver, CO 80203 DATE +s d-l <br />(30~) 866-3567 , ~ <br />RECt3vEO rf+aA . ~ <br />n-E s~nA aF <br />,~ Y <br />o,A,ta~rrr aF ACY17lfVT...... $ <br />/IM]lR~ff PAU ................ $ <br />ea .rioE aE .............. $ <br />'~~ <br />MINED LAND RECLAMATION DIV JN N 0 17 6 2 <br />1313 Sherman Street Room 423 <br />Denver, CO 80203 ~~ <br />(30) 8(~(~~~6))6-~~3,,567 /`T' q~ .Q DATE ~__I S ~ <br />RECEIVED FROM~"~^'1 ~Z.t "~' ~^ <br />NorK ~ <br />THE SUM OF ~1 w~BOLLARS $~~ ~/~~ <br />) ~cnsH <br />G `/ ~ / HECK <br />FOR V1 ` ^~no <br />AMOUNT OF ACGOU T......$ J ~an Qul <br />AMOUNT PAID ................ $ <br />BALANCE DUE ............... $ 8Y <br />m I ARC $ ~~ C <br />-~gy 1~L2~ ~` <br />~'~a~k ~ou( <br />~. .. n <br /> <br />