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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1997015 <br />Washington County <br />Jason Lockard <br />150 Ash Avenue <br />Akron CO 807200000 <br />Receipt #: <br />Date: <br />Permit: <br />22713 <br />01/03/2017 <br />M 1997015 <br />r7rCheck <br />#8383Minerals <br />Amendment Fees $2,229.00 <br />AM02 <br />Receipt Total: $2,229.00 <br />Page 1 of 1 <br />