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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1989030 <br /> San Miguel County Receipt#: 21421 <br /> Mike Horner Date: 05/04/2016 <br /> P.O. Box 426 Permit: M1989030 <br /> Norwood CO 814230000 <br /> Payment Method Revenue Code Fee Description/Notes Amount <br /> Check#81365 4300-MAFO Minerals Annual Fees $791.00 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />