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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2014008 <br /> 11 Washington County Receipt#: 21510 <br /> Steve Williams Date: 05/23/2016 <br /> 11920 Co. Rd. CC <br /> P.O. Box 32 Permit: M2014008 <br /> Anton CO 808010000 <br /> MethodPayment Revenue Code • • • Amount I <br /> Check#81984 4300-MAFO Minerals Annual Fees $791.00 <br /> One check, two permits(TOT: $1,582.00). <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />