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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978107 <br />Montezuma County <br />000000000 <br />26575 jwd 14300-01 1 Minerals Annual Fees <br />M- 1978 -107 <br />Receipt #: <br />Date: <br />Permit: <br />16195 <br />10/17/2013 <br />M1978107 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />