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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2000041 <br /> Fremont Paving & Redi-Mix, Inc. Receipt#: 21659 <br /> Jodi Ricker Date: 06/16/2016 <br /> 839 MacKenzie Avenue <br /> P.O. Box 841 Permit: M2000041 <br /> Canon City CO 812150000 <br /> MethodPayment Revenue Code • . Amount <br /> Check#090714 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />