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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981220 <br />San Miguel County <br />000000000 <br />Receipt #: <br />Date: <br />Permit <br />16359 <br />11/15/2013 <br />M1981220 <br />P ment Method <br />Revenue C, <br />Fee Description /Notes <br />Amount . Y <br />Is I <br />Minerals Annual Fees <br />M-1981-220 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />