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<br /> MINED LAND RECLAMATION DIVE,. .J NO 2570 <br /> - -1313 Sherman Street Room 423 <br /> Denver, CO 80203 DATE l o+ z 2 ~s `6`~ <br />(3 <br />03 <br />) 866-3567 <br /> Q <br />~ <br />RECEIVED RaOM ~'^"~ C:. `-~ <br /> THE SUM OF C~ y~-_s4]Y~ '~ ~~/ a ~ DOLLARS $ 1 DD . D O <br /> -(. ~^/ca''s+ <br />FOR Ctin~~ ~ g Z~ ~Z ~ ~ I A Z ry~r+ECK <br />^MO <br /> <br /> AMOUNT OF ACCOUNT...... $ <br />! <br />~ <br />~/ ` <br />nQ <br />~ ~oUl <br /> / <br />` <br />ll <br />v <br />AMOUNT PAID ................ $ 1A11 <br /> <br />$ BY <br />BALANCE DLIE.. ....... <br /> <br />