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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1980233 <br /> Costilla County Receipt#: 25684 <br /> Christopher Rodriguez Date: 12/11/2017 <br /> P.O. Box 130 <br /> Permit: M1980233 <br /> San Luis CO 811520000 <br /> MethodPayment Revenue Code • • • <br /> Check#18120 4300-MAFO Minerals Annual Fees $3 3.00 <br /> User: sdt <br /> Payer: Costilla County General Fund Accounts Payable <br /> Due 12/11/16 <br /> Check#18120 inerals Civil Penalty/Violation Fines $323.00 <br /> User: sdt <br /> Payer: Costilla County General Fund Accounts Payable <br /> Infraction Number: MV2017053 <br /> Receipt Total: $646.00 <br /> Page 1 of 1 <br />