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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1978192 <br /> Chaffee County Receipt#: 21525 <br /> Mark Stacy Date: 05/23/2016 <br /> P.O. Box 699 <br /> Permit: M1978192 <br /> Salida CO 812010000 <br /> Payment Meth Revenue Code Fee Description/Notes Amount <br /> Check#145359 4300-MAFO Minerals Annual Fees $323.00 <br /> ONE check, THREE permits(TOT: $1905.00). <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />