2016-08-24_REVISION - M1977365

• Permit No: M1977365
• IBM Index Class Name: REVISION
• Doc Date: 8/24/2016
• Doc Name: Request for Technical Revision
• From: Park County Public Works Department
• To: DRMS
• Type & Sequence: TR2
• Email Name: MAC
• Email Name: WHE
• Media Type: D
• Archive: No

Division of Reclamation, Mining, and Safety
Fee Receipt for M1977365
Park County Receipt#: 22051
Tammie Crawford Date: 08/24/2016
P.O. Box 147
Permit: M1977365
Fairplay CO 804400000
Check#028299 4300-MTRO Minerals Technical Revision $216.00
TR02
Receipt Total: $216.00
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