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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2010054 <br />810890000COWalsenburg <br />P.O. Box 455 <br />Timothy Williams <br />Receipt #: <br />12/11/2017 <br />25680 <br />Date: <br />M2010054Permit: <br />Timothy D. Williams & Betty J. Williams <br />Fee Description/NotesRevenue CodePayment Method Amount <br />Check #5378 $323.004300-MAF0 Minerals Annual Fees <br />User: sdt <br />Payer: Tim or Pam Williams <br />Due 12/8/17 <br />$323.00Receipt Total: <br />Page 1 of 1