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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1993030 <br />Joseph L. Dorris <br />Joseph Dorris <br />2920 Cedar Heights Dr <br />Colorado Springs CO 809040000 <br />Receipt #: <br />Date: <br />Permit: <br />23155 <br />03/23/2017 <br />M1993030 <br />Check #8852 4300-MAFO Minerals Annual Fees $86.00 <br />User: sdt <br />Payer: Pinnacle 5 Minerals LLC Joseph L. or Susan M. <br />Dorris <br />Due 04/26/17 <br />Receipt Total: $86.00 <br />Page 1 of 1 <br />