2016-10-31_REPORT - M1978107

• Permit No: M1978107
• IBM Index Class Name: REPORT
• Doc Date: 10/31/2016
• Doc Name: Annual Fee/Report/Map
• From: Tozer Pit
• To: DRMS
• Annual Report Year: 2016
• Email Name: LJW
• Media Type: D
• Archive: No

Division of Reclamation, Mining, and Safety
Fee Receipt for M1978107
01 Montezuma County Receipt#: 22428
Rob Englehart Date: 10/31/2016
1680 North Dolores Road
Permit: M1978107
Cortez CO 813210000
Check#29673 4300-MAFO Minerals Annual Fees $791.00
Due 11/2/16
Receipt Total: $791.00
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