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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1978093 <br /> Colorado Lien Company Receipt#: 22227 <br /> Clint Beck Date: 09/23/2016 <br /> P.O. Box 440 <br /> Permit: M1978093 <br /> Rapid City SD 577090000 <br /> MethodPayment Revenue Code . • • Amount <br /> Check#250573 4300-MAFO Minerals Annual Fees $791.00 <br /> Due 9/22116- Fee only rec'd! <br /> Receipt Total: $791.00 <br /> RECEIVED <br /> SEP 2 21016 <br /> DIVISION OF RECLAMATION, <br /> &SAFETY-MINERALS <br /> REPORT MAp FW <br /> I <br /> Page 1 of 1 <br />