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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1989023 <br /> Kristine M Couch Receipt#: 23047 <br /> Kristine Couch Date: 03/06/2017 <br /> 6963 S. Olive Way <br /> Permit: M1989023 <br /> Centennial CO 801120000 <br /> MethodPayment Other <br /> Check#176 4300-MAFO Minerals Annual Fees $323.00 <br /> Couch Family Farm LLC <br /> Due 03/09/17 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />