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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1989095 <br /> Phillips County Receipt#: 25602 <br /> Randy Schafer Date: 11/27/2017 <br /> 221 S. Interocean Ave. <br /> Permit: M1989095 <br /> Holyoke CO 807340000 <br /> me ttOnu co. r n, �. � :... �• �;... �' WIZ,: <br /> Check#42357 4300-MAFO Minerals Annual Fees $791.00 <br /> User: sdt <br /> Payer: Board of Phillips County Commissioners <br /> Due 11/27/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />