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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977567 <br />Saguache County <br />000000000 <br />Receipt #: 20630 <br />Date: 11/24/2015 <br />Permit: M1977567 <br />Payment Method Revenue Code <br />Fee Description/Notes <br />Amount <br />65243 SDT <br />4300-MAFO <br />Minerals Annual Fees <br />M1977-567 <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />