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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977136 <br />Rio Blanco County <br />000000000 <br />139990 SMS 1 4300 -01 1 Minerals Annual Fees <br />M1977 -136 <br />Receipt #: <br />Date: <br />Permit: <br />16849 <br />02/14/2014 <br />M1977136 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />