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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1995019 <br /> Baca County Receipt#: 23415 <br /> Glen Ausmus Date: 05/03/2017 <br /> 741 Main St.,Suite 1 <br /> Permit: M1995019 <br /> Springfield CO 810730000 <br /> MethodPayment Revenue Code . • Amount <br /> Check#121955 4300-MAFO Minerals Annual Fees $791.00 <br /> User: MSR <br /> 2017 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />