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~~a~~w.a <br /> <br /> MINED LAP~~ RECLAMATION DIVISION ~ Q Q 5 O2 5 <br /> 1313 S. Oman Street Room 42'' ~- -, <br /> Denver, CO 80203 "`~ r ?" PATE ~ O~ 95 <br /> (303) 866-3567 <br /> ~~D ~ kJ ~ <br />RECEIVED FROM <br />Q^ <br /> / <br />/^ <br />~~ <br />THE SUM OF ~yiiiQ,Q ~ .Qn n.rN~._ I~._t_~J na-1pLLARS $ y~SC./' DO <br />^ CnSH <br /> FOR __~ ~n_-~-.ee m- xo- b3~-Fig s-~~a~o~K <br /> AMOUNT OF ACCOUNT...... $ ~ <br />IQ~~ ~ <br />u~ <br />~- <br />l <br />~ <br /> Y <br />v <br />AMOUNT PAID ................ $ U <br />~ <br />j <br />V / <br /> 9ALANCE DUE .......... . .... $ 8Y / ~ '` ~ G~ L[~ <br /> <br />