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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1988101 <br /> Elbert County Receipt 22635 <br /> #: <br /> Kelly Moore Date: 12/08/2016 <br /> P.O. Box 116 <br /> Permit: M1988101 <br /> Kiowa CO 801170000 <br /> MethodPayment Revenue Code Fee Description/Paid By Other Entity/Notes Amount <br /> Check#23340 4300-MAFO Minerals Annual Fees $791.00 <br /> Due 12/15/16 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />