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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1986016 <br /> Caldwell Brothers Receipt#: 21581 <br /> Wayne Caldwell Date: 06/01/2016 <br /> 25026 Rd 19 <br /> Permit: M1986016 <br /> Rocky Ford CO 810670000 <br /> Payment MetholIF'Revenue,Code • • • Amount <br /> Check#1751 4300-MAFO Minerals Annual Fees $791.00 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />