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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1995O27 <br /> Park County Receipt#: 23447 <br /> Tammie Crawford Date: 05/09/2017 <br /> P.O. Box 147 <br /> Permit: M1995027 <br /> Fairplay CO 804400000 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#031076 4300-MAFO Minerals Annual Fees $791.00 <br /> User: MSR <br /> 2017 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />