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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2000110 <br /> Bassi North Farm, LLC Receipt#: 25248 <br /> Richard Bassi Date: 0 912 0/2 0 1 7 <br /> 2046 Lake Avenue <br /> Permit: M2000110 <br /> Pueblo CO 810040000 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#1601 4300-MAFO Minerals Annual Fees $791.00 <br /> User: MSR <br /> 2017 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />