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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2013014 <br /> Kit Carson County Receipt#: 21496 <br /> Paula Weeks Date: 05/19/2016 <br /> 251 16th Street <br /> P.O. Box 160 Permit: M2013014 <br /> Burlington CO 808070000 <br /> MethodPayment Revenue Code Fee Description/Notes Amount <br /> Check#120534 4300-MAFO Minerals Annual Fees $323.00 <br /> ONE check, TEN permits($4,166 total) <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />