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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for MI977479 <br /> Baca County Receipt#: 22064 <br /> Glen Ausmus Date: 08/24/2016 <br /> 741 Main St.,Suite 1 Permit: M1977479 <br /> Springfield CO 810730000 <br /> MethodPayment Revenue CodeDescription/Notes <br /> Check#119743 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />