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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for MI 981154 <br /> San Miguel County Receipt#: 22561 <br /> Mike Horner Date: 11/22/2016 <br /> P.O. Box 426 Permit: M 1981154 <br /> Norwood CO 814230000 <br /> ISO* 0-1 <br /> A <br /> Check#82698 4300-MAFO Minerals Annual Fees $791.00 <br /> Due 11/20/16 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />