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Division of Reclamation, Mining, and Safety <br />Fee Receipt for MI 992060 <br />City of Monte Vista <br />Forrest Neuerburg <br />95 W, 1st <br />Monte Vista CO 811440000 <br />Receipt #: <br />Date: <br />Permit: <br />25474 <br />10/31/2017 <br />M1992060 <br />• - .. <br />......... .._ <br />- <br />i ...� <br />.. <br />- <br />;- <br />Check #027805 <br />4300-MAFO <br />Minerals Annual Fees <br />User: sdt <br />Due 10/20/17 <br />$32300 <br />Receipt Total: <br />1 $323.00 <br />Page 1 of 1 <br />