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Division of Reclamation, Mining, and Safety <br />Fee Receipt for P2017006 <br />Amazonite Mining, LLC <br />Jeffrey Forrest <br />8057 S. Vermejo Peak <br />Littleton CO 801270000 <br />Receipt #: <br />Date: <br />Permit: <br />23216 <br />04/07/2017 <br />P2017006 <br />Page 1 of 1 <br />O <br />Check #336 <br />4300-PNOI <br />Minerals Prospecting Application Fee1N01 <br />$1,006.00 <br />User: MSR <br />Payer: Jeffrey S. Forrest or Betsy C. Forrest <br />new application <br />Receipt Total: <br />1 $1,006.00 <br />Page 1 of 1 <br />