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iii iiiiiiiiiiiiiii~ <br />999 <br />MINA <br />LAND RECLAMATION DIVISION <br />1313 Sherman, Rm. 215 <br />Denver, Colorado 80203 <br />., (303) 866-3567 <br />N°_ 22069~j <br />DATE _~L~ `~ _ 'I 9 ( 2 <br />$ <br />~~ <br />DOLLARS <br />^ CASH <br />44j ~y 5-6NECK <br />RECEIVED <br /> <br />AMOUNT OF A~COUNT...... .. .$ <br />AMOUNT PAID ....... .. .......$ <br />BALANCE DUE ......... .. ......$ <br />`~ ~ U~ <br />BV <br />