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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1990138 <br />Fremont County <br />Receipt #: 20759 <br />Date: 12/29/2015 <br />Permit: M1990138 <br />Payment Method Revenue Cod <br />DescriptionlNotes <br />oun <br />Check # 111036 <br />4300-MAFO <br />Minerals Annual Fees <br />M-1990-138 <br />$323.00 <br />Receipt Total: <br />$323.00 <br />Page 1 of 1 <br />