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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1987097 <br /> Conejos County Receipt#: 21971 <br /> Phil Esquibel Date: 08/10/2016 <br /> P.O. Box 157 <br /> 6683 County Rd 13 Permit: M1987097 <br /> Conejos CO 811290000 <br /> MethodPayment Revenue Code Fee Description/Notes Amount <br /> Check*034740 4300-MAFO Minerals Annual Fees $323.00 <br /> 2016 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />