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iiti~iii~~iiii~i~i~i <br /> <br /> MINED 1D RECL4MATION DIVISION r"~ 2128 <br />lil3 Sherman, Rm. 215 ,~• <br />Denver, Colorado 80203 DATE ~~__ is Q Z <br />(303) 866-3567 <br /> RECEIVED / //'~~ ~ ~//1 $~U <br />~ <br />~ <br />( <br /> !'Q <br />~ <br />u nn.llyh,. ///l.LU7 . T <br />FROM <br /> ~ <br />~~ <br />~~ <br />~ <br />~ <br /> .LLtQ <br />dS.6~_ <br />Aq <br />p <br />- <br />~ <br />DOLL4R5 <br /> ,. <br />_ <br /> ^ CASH <br />~G ',CHECK <br />FOR a~WVI~ .Q-L. ~n - 7 7Z -C1 J' Y ~ 3 L+X" Z' ^ M.O. <br /> <br /> AMOUNT OF ACCOUNT..... ... .$ <br />AMOUNT PA10 ... ... ...........$ ~ Z OU! <br /> BALANCE DUE ........ ... ... ..$ BY <br /> <br />