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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1999024 <br /> Costilla County Receipt#: 25685 <br /> Christopher Rodriguez Date: 12/11/2017 <br /> P.O. Box 130 <br /> Permit: M1999024 <br /> San Luis CO 811520000 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#18120 4300-MAFO Minerals Annual Fees $791.00 <br /> User: sdt <br /> Payer: Costilla County General Fund Accounts Payable <br /> Due 10/4/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />