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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1998080 <br /> H & H Stone Receipt#: 21361 <br /> Betty Holley Date: 04/25/2016 <br /> P.O. Box 246 Permit: M1998080 <br /> Dove Creek CO 813240000 <br /> Payment Method Revenue Code Fee Description/Notes Amount <br /> Check#3337 4300-MAFO Minerals Annual Fees $323.00 <br /> 2013 <br /> Check#3337 4300-MAFO Minerals Annual Fees $323.00 <br /> 2014 <br /> Check#3337 4300-MAFO Minerals Annual Fees $323.00 <br /> 2015 <br /> Check#3337 5700 Minerals Civil Penalty/Violation Fines $323.00 <br /> Receipt Total: $1,292.00 <br /> Page 1 of 1 <br />