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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1977075 <br /> Phillips County Receipt#: 22270 <br /> Randy Schafer Date: 09/30/2016 <br /> 221 S. Interocean Ave Permit: M1977075 <br /> Holyoke CO 807340000 <br /> NO Raw <br /> Check#38654 4300-MAFO Minerals Annual Fees $791.00 <br /> Due 9/27/16 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />