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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1995026 <br /> Custer County Receipt#: 21963 <br /> Rusty Christensen Date: 08/09/2016 <br /> P.O. Box 1669 Permit: M1995026 <br /> Westcliffe CO 812520000 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#58897 4300-MAFO Minerals Annual Fees $791.00 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />