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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for MI977283 <br /> Adams County Receipt#: 25739 <br /> Kurt Carlson Date: 12/22/2017 <br /> 9755 Henderson Rd. <br /> Permit: M1977283 <br /> Brighton CO 806010000 <br /> MethodPayment Revenue Code Fee Description/Notes <br /> Check#717625 4300-MAFO Minerals Annual Fees $791.00 <br /> User: sdt <br /> Payer: Adams County, State of Colorado <br /> 12/21/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />