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RECEIVED <br /> MAY 12 2016 <br /> T Division of Reclamation, Mining, and Safety <br /> oiv si�t�'v " .k7:.::LAMATION <br /> MGsAF> 1�► Fee Receipt for M1999043 <br /> Lincoln County Receipt#: 21469 <br /> John DeWitt Date: 05/12/2016 <br /> P.O. Box 39 <br /> Permit: M1999043 <br /> Hugo CO 808210000 <br /> Payment Method Revenue Code Fee Description/Notes Amount <br /> Check#31086 4300-MAFO Minerals Annual Fees $323.00 <br /> 2016 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />