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III 1111111111111111 <br /> <br /> MINED ._ .JD RECLAMATION DIVISION N? 14154 <br /> 1313 Sherman, Rm. 2!5 <br /> Denver, Colorado 802[3- ~ DATE 9~~5 ~9~ <br /> 66-3567 <br />(303) <br />8 <br /> / ~ $ <br />// <br />_ <br />ED <br />/~ <br />~ <br />~7 <br />' <br />~ <br />' <br />~ <br />~ <br /> 7~/~i <br />l <br />LLC-/ <br />( <br />6 <br />/7~U~~G(! <br />ROM <br />~( L <br /> <br /> / ,/ n~~ <br />n 9 n_ ~ a ,,,, r,4 ti~,rY ~~~ dz~~ r ~C'~OLLARS <br /> ^~/~ r^ CASH <br />B <br />'C <br />R <br />ECK <br />~ ~ 7-~ <V <br />~ 3 <br /> ^ <br />D <br />M <br />c <br />/ <br />FOR <br /> <br /> AMOUNT OF ACCDU .... ......5 IA '^I^ <br />I <br />~ <br /> lIQYIK ou <br />AMOUNT PAID ......... .........~ <br />7 <br /> BAlM1CE DUE ...................$ B`l~7 '~i~~(//y~ <br /> <br />