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Baca County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2003070 <br />111111111 <br />Receipt #: 16655 <br />Date: 01/09/2014 <br />Permit: M2003070 <br />puTyP771 _71!A 7; <br />110369 msr <br />4300 -01 <br />Minerals Annual Fees <br />M2003 -070 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />