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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1976059 <br /> Skanska USA Civil West Rocky Mountain Dist Receipt#: 21567 <br /> Jennifer Holland Date: 06/01/2016 <br /> 22419 CR G <br /> P.O. Box 1660 Permit: M1976059 <br /> Cortez CO 813210000 <br /> Payment Method Revenue Code Fee Description/Notes Amount <br /> Check#53610 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />