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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2016024 <br /> Haynes Excavation, Inc. Receipt#: 21913 <br /> Todd Haynes Date: 07/29/2016 <br /> 12696 6450 Rd <br /> Permit: M2015024 <br /> Montrose CO 814010000 <br /> MethodPayment Revenue Code • • • <br /> Check#1903 4300-MAFO Minerals Annual Fees $323.00 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />