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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2000018 <br /> Cheyenne County Receipt#: 23426 <br /> Marcy Brossman Date: 05/04/2017 <br /> 51 S. 1st. <br /> P.O. Box 567 Permit: M2000018 <br /> Cheyenne Wells CO 808100000 <br /> MethodPayment Revenue Code • . <br /> Check#81008 4300-05 Minerals Miscellaneous $323.00 <br /> User: MSR <br /> 2017 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />