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• iii iiiiiiiiiiiii iii • <br />999 <br /> <br /> MINED LAND RECLAMATION DIVISION N~ 16363 <br /> 1313 Sherman, Rm. 115 <br /> Denver, Colorado 80103 DATE <br />~~ t 9~( <br /> _ <br />_ <br />(303) 866-3567 <br /> RECEIVED $ <br />RaOM $ ~S. ~ <br /> - ~~DOLLARS <br /> O CASH <br />H <br />K <br />C <br />'lC <br /> O <br />~~1 <br />^ <br />M <br />Ln_n~ ~j/-OX3 Q `f 1v <br />FDR C <br /> ~ <br /> AMOUNT OF ACCOUNT...........$ ~A ~f /I~A1 /I1' <br />I <br />~ <br /> QU <br />AMCUNT PAID..... V IIQII <br /> BALANCE DUE ...................$ BY ~ C-sila^+~____~' -~ <br /> <br />