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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1983178 <br />Bent County <br />000000000 <br />Receipt #: <br />Date: <br />Permit: <br />18503 <br />11/04/2014 <br />M1983178 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />028238 msr <br />4300 -MAFO <br />Minerals Annual Fees <br />M 1983 -178 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />