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a ~~ <br />5 ~ ~ a ~~ <br /> ~ <br />o <br />m ~ <br />O <br /> D <br />~ <br /> O <br /> y- <br />~~~r <br />m <br />~AI ' <br />[~ 0 <br />- !Cw ~ m <br />/~ ~ Z <br />\~V~ ^tEl ?.1" 'gyp <br />1 ~ N <br />o ~ ~ <br />~ ~^ o~ U m CO <br />~r~ o „p W <br />Omfnli ~\ ~ 1--• <br />~ ~/ <br />MINED LAND RECLAMATION DIVISION N~ 0 0 8 5 9 7 <br />1313 Sherman ~~ __ JJ ~~ ~~ c~` <br />Denver, Colorado 80203 GATE ~ t B1L- <br />(303) 866-3567 ,y~~n n .- _ r~ $ <br />RECEIVED c ~ ~ on'T-nn m ~ 6l Q.C~Q~^"' ~"'~ 7'SC ~ (~ <br />FROM 7 <br />,~ ,~ ~ ~ ~, DOLLARS <br />O CASH <br />CHECK <br />FOR LFi~n.N "a0~ 7 7~"J7 OM.O. <br />)SU.oo ?J0. O.OD <br />AMOUNT OF ACCOUNT..... .... .$ ~ QUI <br />AMOUM PAID .......... .......$ ', <br />BY <br />BALANCE DUE . .................$ <br /> <br /> MINED JD RECLAMATION DIVISION ~" 013275 <br /> I~r3 Sherman, Room 215 <br /> Denver, Colorado 80203 (y _ d ~ ~j('~ <br />DATE ~9 <br /> 303) 866-3567' <br /> 10 <br />(~ ~ <br />$ 7 <br />~ <br />ED <br />" <br /> .5(]. <br />L~.~ <br />% <br />L~ <br />l <br />. <br />r, <br />W <br />~ <br />~e. <br />,~,N ~-Rw-n~ <br />OM <br />I <br />lS <br />FR <br /> ~ <br />/~ <br />~~ ( <br />J7 <br />(,~' <br />J/[ <br />~~) <br />' <br />- <br />~ <br />J <br />., <br />~ <br />' <br />~~ <br /> '~'-~-IJQ~ .(.~/Y1l'iL /KJ( %i~R Ali <br />I I ARS` <br />~ <br /> ^ DABH <br />~ <br /> r bra -a-~'EDK <br />FDR > i'1= ~7. a yR/3 v i1~olr~ <br />^ M.O. <br /> <br /> V <br />AMOUNT OF ACCOUNT...........$ /1°I I n ~ <br />~ ~Q ~ ~~ u <br /> AMOLIM PAID ...................$ <br /> BALANCE OUE ...................$ BV <br /> <br /> <br /> MINED 1D RECLAMATION DIVISION ~' 16204 <br />Isla Sherman, Rm. 215 <br /> Denver, Colorado 80203 ~ _ <br />__t__~ <br />~is.~ <br />03)866-3567 DarE <br />( <br /> -3 <br />n <br />/ <br />--} <br />$ <br />R <br />~ <br />ED <br />~ <br />~ <br /> ® <br />l6frL2n`SF <br />1 ~?' `~, .I 0~h <br />FROM <br />lf'7i1 Vi211 <br /> , <br />, <br /> <br /> FORQcW)'l %LCfJ //" / ~ ~ cJIL/~ 0~7~CK <br /> <br /> AMOUNT PAID ........ .... .....$ Il `~'JA <br /> BALANCE DUE .... ...............$ BY <br /> <br />