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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2005059 <br />Asphalt Specialties Co., Inc. <br />Rob Laird <br />10100 Dallas St. <br />Henderson CO 806400000 <br />Check #040250 1 4300-MAFO I Minerals Annual Fees <br />Due 03/01/17 <br />Receipt #: <br />Date: <br />Permit: <br />23003 <br />02/24/2017 <br />M2005059 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />