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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2010036 <br /> Rick Ensminger Receipt#: 21934 <br /> Rick Ensminger Date: 08/02/2016 <br /> P.O. Box 276 <br /> Permit: M2010036 <br /> Haxtun CO 807310000 <br /> Payment • • Revenue Code • • • Amount <br /> Check#3713 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />