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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M199O144 <br /> R. Lewis Fillmore Receipt#: 27341 <br /> Ron Fillmore Date: 08/30/2018 <br /> 63985 Highway 96 E <br /> Permit: M1990144 <br /> Boone CO 810250000 <br /> 'Method Revenue Code Fee Description/Notes Am <br /> Check#2112 5700 Minerals Civil Penalty/Violation Fines $791.00 <br /> User: sdt <br /> Payer: Ronald Fillmore <br /> (,�fn�it 'on Number: MV2018030 <br /> ERR <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />