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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2003070 <br /> Baca County Receipt#: 22781 <br /> Peter Dawson Date: 01/17/2017 <br /> 741 Main St.,Suite 1 Permit: M2003070 <br /> Springfield CO 810730000 <br /> Check#121076 4300-MAFO Minerals Annual Fees $791.00 <br /> 01/08/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />