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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1999077 <br />813210000COCortez <br />1680 North Dolores Road <br />Rob Englehart <br />Receipt #: <br />10/26/2016 <br /> 22419 <br />Date: <br />M1999077Permit: <br />Montezuma County <br />Fee Description/Paid By Other Entity/NotesRevenue CodePayment Method Amount <br />Check #29625 $791.00 4300-MAF0 Minerals Annual Fees <br />2016 <br />$791.00 Receipt Total: <br />Page 1 of 1