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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1978221 <br /> #17 Enterprises, LLC Receipt#: 21886 <br /> Scott Stewart Date: 07/28/2016 <br /> 0275 CR 22 <br /> P.O. Box 88 Permit: M1978221 <br /> DeBeque CO 816300000 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#25573 4300-MAFO Minerals Annual Fees $323.00 <br /> 2016 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br /> 1 <br />