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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1981058 <br /> Thomas F &Ginger L Latham Receipt#: 22129 <br /> Thomas Latham Date: 09/08/2016 <br /> P.O. Box 66 <br /> Permit: M1981058 <br /> DeBeque CO 816300000 <br /> Check#013605 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />