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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1981058 <br /> Thomas F& Ginger L Latham Receipt#: 25249 <br /> Thomas Latham Date: 09/20/2017 <br /> P.O. Box 66 <br /> Permit: M1981058 <br /> DeBeque CO 816300000 <br /> Method Revenue Code • • Amount <br /> Check#021744 4300-MAFO Minerals Annual Fees $791.00 <br /> User: MSR <br /> Payer: RBK Construction, Inc. <br /> 2017 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />