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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981158 <br />Forest Lakes Metro District <br />000000000 <br />Receipt #: 20846 <br />Date: 01/21/2016 <br />Permit: M1981158 <br />Payment Method <br />Revenue Code <br />Fee Description/Notes <br />`� �� Amount <br />023424 SDT <br />4300-MAFO <br />Minerals Annual Fees <br />M1981-158 <br />$323.00 <br />Receipt Total: <br />$323.00 <br />Page 1 of 1 <br />