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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1997035 <br /> Park County Receipt#: 21664 <br /> Tammie Crawford Date: 06/16/2016 <br /> P.O. Box 147 <br /> Permit: M1997035 <br /> Fairplay CO 804400000 <br /> MethodPayment Revenue CodeDescription/Notes <br /> Check#027520 4300-MAFO Minerals Annual Fees $323.00 <br /> 2016 <br /> F777Teceipt Total: $323.00 <br /> Page 1 of 1 <br />