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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1979059 <br /> Coulson Excavating Company, Inc. Receipt#: 22322 <br /> Richard Coulson Date: 10/12/2016 <br /> 3609 North County Road 13 <br /> Permit: M1979059 <br /> Loveland CO 805380000 <br /> Check#12345 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />