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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1994103 <br /> Costilla County Receipt#: 25683 <br /> Christopher Rodriguez Date: 12/11/2017 <br /> PO Box 130 <br /> Permit: M1994103 <br /> San Luis CO 811520000 <br /> MethodPayment ReVdhU6 Code • • e • <br /> Ch ck 8 0 4300-MAFO Minerals Annual Fees $ .00 <br /> User: sdt <br /> Payer: Costilla County General Fund Accounts Payable <br /> Due 6/6/17 <br /> Check#18120 - in ra s nnua ee 323.00 <br /> User: sdt <br /> Payer: Costilla County General Fund Accoun yable <br /> Check#18120 5700 Minerals Civil PerfaltyNiolation Fines $323.00 <br /> -r: sdt <br /> Payer: Costilla County General Fund Accounts Payable <br /> Infraction Number: MV2017052 <br /> Receipt Total: $969.00 <br /> Page 1 of 1 <br />