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RECEIVED <br />OCT 0 6 2015 <br />DlVlSl0.-.,.- ,,..,-LAMATION <br />MSAFETY-NWERAci <br />F) REPORT MAP` 199, <br />lm�// <br />Costilla County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1994103 <br />Receipt # <br />Date <br />Permit: <br />20363 <br />10/06/2015 <br />M 1994103 <br />Receipt Total: $646,00] <br />Page 1 of 1 <br />10574 rnsr <br />4300-MAFO <br />Minerals Annual Fees <br />M1994-103 MV2015-0182014 Annual Fees - <br />$323.00 <br />10574 rnsr <br />5700 <br />Minerals Civil PenaltyNiolation Fines <br />M1994-103 MV2015-018 <br />$323.00 <br />Receipt Total: $646,00] <br />Page 1 of 1 <br />