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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1977425 <br /> Receipt#: 21435 <br /> Larimer County <br /> Justin Hersh Date: 05/05/2016 <br /> P.O. Box 1190 Permit: M1977425 <br /> Fort Collins CO 805220000 <br /> Payment Method Revenue Code Fee Description/Notes Amount <br /> Check#374047 4300-MAFO Minerals Annual Fees $791.00 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />