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Division of Reclamation, Mining, and Safety <br />Fee Receipt for MI 996073 <br />Sedgwick County <br />Rick Furrow <br />223 S Cedar <br />Julesburg CO 807370000 <br />Receipt #: <br />Date: <br />Permit: <br />25540 <br />11/14/2017 <br />M1996073 <br />Page 1 of 1 <br />Check #081942 <br />4300-MAFO <br />Minerals Annual Fees <br />$32300 <br />User: sdt <br />Due 1118117 <br />Receipt Total: <br />$323.00 <br />Page 1 of 1 <br />