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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1988101 <br /> Elbert County Receipt#: 25664 <br /> Kelly Moore Date: 12/05/2017 <br /> P.O. Box 116 Permit: M1988101 <br /> Kiowa CO 801170000 <br /> • • • • • • • • <br /> Check#28568 4300-MAFO Minerals Annual Fees $791.00 <br /> User: sdt <br /> Payer: Elbert County Treasurer <br /> Due 12/15/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />