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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2016002 <br />Donald J. Self Receipt#: 20893 <br />Date: 01/29/2016 <br />Permit: M2016002 <br />000000000 <br />Payment Method Revenue Code Fee Description/Notes Amount <br />0993 msr 4300-MAPP Minerals Application Fees 288.00 <br />M2016-002 paid by Colorado Blue, LLC <br />Receipt Total: 288.00 <br />Page 1 of 1