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Baca County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981138 <br />Payment Method Revenue Code <br />Fee Description/Notes Amount <br />101826 <br />4300-01 <br />Minerals Annual Fees <br />M-1981-138 <br />$791.00 <br />Receipt Total: I $791.00 <br />Receipt #: 10824 <br />Date: 06/22/2011 <br />Permit: M1981138 <br />Page 1 of 1 <br />