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RECFIVED <br /> MAY 2`i 2017 <br /> v.=;;L,MATION Division of Reclamation, Mining, <br /> MINING&SAFETY-MINERAL. 9 Safety <br /> 6'-_EE RO-OW �AP� <br /> //�� Fee Receipt for M2011049 <br /> City of Greeley Receipt#: 23555 <br /> Anastasia Frantsova Date: 05/26/2017 <br /> 1100 1 Oth Street, Suite 300 Permit: M2011049 <br /> Greeley CO 806310000 <br /> MethodPayment Revenue Code Fee Description/Notes Amount <br /> Check#349995 4300-MAFO Minerals Annual Fees $791.00 <br /> User: MSR <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />