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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1984043 <br /> Pelino, Inc. Receipt#: 21925 <br /> Scott Pelino Date: 08/02/2016 <br /> P.O. Box 5049 <br /> 33551 County Road 361 Permit: M1984043 <br /> Buena Vista CO 812110000 <br /> MethodPayment Revenue Code Fee Description/Notes Amount <br /> Check#4656 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />