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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1990144 <br /> R. Lewis Fillmore Receipt#: 25575 <br /> Ron Fillmore Date: 11/20/2017 <br /> 63985 Highway 96 E <br /> Permit: M1990144 <br /> Boone CO 810250000 <br /> ''ay t nt= et,°, , fed nub o t .Op ;ii/Notes ..... r... •Atim9tint <br /> Check#2011 4300-MAFO Minerals Annual Fees $791.00 <br /> User: sdt <br /> Payer: Ronald Fillmore <br /> Due 6/15/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />