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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M197714O <br /> Mathias Concrete, Inc. Receipt#: 22757 <br /> Thomas Mathias Date: 01/10/2017 <br /> 1500 N. Farm Rd. Permit: M1977140 <br /> P.O. Box 266 <br /> Monte Vista CO 811440000 <br /> Payment Method Revenue Code Fee Description/Paid By Other Entity/Notes Amount <br /> Check#14467 4300-MAFO Minerals Annual Fees $791.00 <br /> Due 01/15/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />