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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1997089 <br /> Daren Stone Receipt#: 23723 <br /> Daren Stone Date: 06/27/2017 <br /> P.O. Box 1568 Permit: M1997089 <br /> Cortez CO 813210000 <br /> MethodPayment Revenue i�ode Fee Dei6ription/146iesAmount <br /> Check#005133 4300-MAFO Minerals Annual Fees $791.00 <br /> User: sdt <br /> Payer: Stone Sand & Gravel LLC <br /> Due 7/8/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />