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<br /> MIP' `LAND RECLAMATION DIVISION N~ 15550 <br /> 1313 Sherman, Rm. 215 _ c~ ~~ ~/ <br />Denver, Colorado 80103 DATE 5 - ( 19__l_ <br />(303) 866-3567 - $ <br />RECEIVED tnJ ~fj-~ .,~ <br /> FROM f P/!'1~1•l ~• /~ <br /> `-my~ <br />~ / ~r <br /> <br /> 1 /h C <br />6•CHECK <br />FOR ~h 0l QD /~ / - O ~ a J3o ^ CASH <br />O <br />L ~ M <br /> . <br />. <br /> AMOUNT OF A OUN7........ .. $ ~ O, I I <br />AMOUNT PAID .. ....... .. .....$ ll <br /> BALANCE OUE ....... ..........$ BV <br /> <br />