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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1985140 <br /> David Goss Receipt#: 22873 <br /> Dean Goss Date: 02/01/2017 <br /> 24040 Falcon Hwy <br /> Permit: M1985140 <br /> Calhan CO 808089156 <br /> Check#7237 4300-MAFO Minerals Annual Fees $323.00 <br /> Dean and Audra Goss 7w' <br /> Due 01/24/17 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />