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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2OO4O52 <br /> Phillips County Receipt#: 21735 <br /> Randy Schafer Date: 06/27/2016 <br /> 221 S. Interocean Ave. <br /> Permit: M2004052 <br /> Holyoke CO 807340000 <br /> Payment • • Revenue Code • • • Amount <br /> 38029 5700 Minerals Civil PenaltyNiolation Fines $500.00 <br /> YEAR: 2016 <br /> Receipt Total: $500.00 <br /> Page 1 of 1 <br />