Laserfiche WebLink
<br /> <br /> <br /> DIV N OF MINERALS AND GEOLOGY IVp 669*r <br /> /~ /J DATE <br />-/ <br />.V~(~C.. ~~ i <br />FROM EO /(T /~ /.G~/L C~ _ <br />~~ <br />f--~ /--~ y/ <br />/ 19~ <br />~~• <br /> ~ <br />/ <br />vv7~G~' ~ /~ ~~ DO R9 <br /> <br /> <br />"~/ S <br />FOR ~G/ - / ~~ ^C <br />^ C <br />^ M H <br />ECK <br /> AMOUNT OF ACCOUNT........... .1 ~/~~~ <br />. (~PI~~I /f /,,^~''~^^ <br />.. /1 ~ <br />L'AOUI <br /> AMOUNT PAID ............... ...~ •`U II IL <br /> BALANCE DUE ... ... ..........$ <br /> <br />