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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1995005 <br /> Mountain Region Corporation Receipt#: 23467 <br /> Sandra DuCray Date: 05/12/2017 <br /> 117 29 3/4 Road <br /> Permit: M1995005 <br /> Grand Junction CO 815030000 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#12999 4300-MAFO Minerals Annual Fees $791.00 <br /> User: MSR <br /> 2017 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />