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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1978071 <br /> Rio Grande County Receipt#: 25604 <br /> Patrick Sullivan Date: 11/27/2017 <br /> 168 N. Washington <br /> Permit: M1978071 <br /> Monte Vista CO 811440000 <br /> i ayn nt MothdRe nuO `Pe D* pato . o _ <br /> o �< � ri ntl tes � `� � in:4M <br /> Check#148253 4300-MAFO Minerals Annual Fees $791.00 <br /> User: sdt <br /> Payer: Board of County Commissioners Rio Grande <br /> County <br /> Due 11/25/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />