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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2013052 <br /> Jean Marie Cowman Receipt#: 23402 <br /> Jean Cowman Date: 05/02/2017 <br /> 1065 S. Woodland Ave. #1 <br /> Permit: M2013052 <br /> Woodland Park CO 808630000 <br /> MethodPayment Revenue Code <br /> Check#1196 4300-MAFO Minerals Annual Fees $259.00 <br /> User: MSR <br /> Payer: Legacy Gems and Minerals, LLC <br /> 2017 <br /> Receipt Total: $259.00 <br /> Page 1 of 1 <br />