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Baca County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977479 <br />111111111, <br />Receipt #: 20217 <br />Date: 09/09/2015 <br />Permit: M1977479 <br />Payment MEW <br />Revenue Code <br />Fee Description/Notes <br />Amount <br />116392 SIDT <br />Minerals Annual Fees <br />M1977-414 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />