Laserfiche WebLink
III IIIIIIIIIIIII III <br />999 <br /> <br />_~ _ <br /> <br /> MINED LAND RECLAMATION DIVISION N~ 19704 <br /> 1313 Sherman, Rm. 215 <br /> [j <br />Denver, Colorado 80]03 DATE --~ r~ / 1s~ <br /> D (303) 866-3567 $ <br />Q <br />Q <br />5 <br />Fa <br />ED <br /> i~.ti!? {.~l~ <br />i~r~ wSG1~~~~•,n~ri~ ~ <br />y nn.cs <br />0. <br />oM <br /> /~ I i <br />~ <br />r <br />a/ <br /> f"llt <br />~t <br />Q <br />Yn <br />~ <br />~' / yid <br />1 <br />ARS <br />004 <br /> nn <br />~ <br />, <br />~/y7TC <br />/ <br />FOR / 1~_ 1110 U/~ /~10~ ~l~ ~7~ ~~IHECK <br /> <br /> AMOUNT OF ACCOUNT. ..........$ '^ I1 <br />fr`~ oul <br /> AMOUNT PAID... ...... <br /> BALANCE DUE . ...... ...... ..$ BV <br /> <br />