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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2004084 <br /> Benson Brothers Receipt#: 21423 <br /> Hans Benson Date: 05/04/2016 <br /> 21240 Austin Rd <br /> Permit: M2004084 <br /> Austin CO 814100000 <br /> Payment Method Revenue Code Fee Description/Notes Amount <br /> Check#039036 4300-MAFO Minerals Annual Fees $791.00 <br /> 1— Receipt Total: $791.00 <br /> Page 1 of 1 <br />