2016-10-28_REPORT - M1990116

• Permit No: M1990116
• IBM Index Class Name: REPORT
• Doc Date: 10/28/2016
• Doc Name: Annual Fee/Report/Map
• From: Kennedy Pit
• To: DRMS
• Annual Report Year: 2016
• Email Name: ERR
• Media Type: D
• Archive: No

Division of Reclamation, Mining, and Safety
Fee Receipt for M1990116
Phillips County Receipt#: 22430
Randy Schafer Date: 10/31/2016
221 S. Interocean Ave. Permit: M1990116
Holyoke CO 807340000
Check#39091 4300-MAFO Minerals Annual Fees $791.00
Board of Phillips County Commissioners
Due 10/26/16
Receipt Total: $791.00
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