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Park County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1995027 <br />[IIIIIIIIIIIIIIII17 <br />Receipt #: 19492 <br />Date: 05/05/2015 <br />Permit: M1995027 <br />Payment Method <br />Revenue <br />Fee Description /Notes <br />owwm <br />1 . <br />11 1 <br />Minerals Annual Fees <br />• 11 <br />1995-027 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />