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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2012004 <br />Superior Oilfield Services Co., LTD <br />Jack Miller <br />1011 11th Ave <br />Greeley CO 806310000 <br />Receipt #: <br />Date: <br />Permit: <br />23757 <br />07/03/2017 <br />M2012004 <br />.. j <br />.T <br />Check #2052 <br />4300-MAFO <br />Minerals Annual Fees <br />$791.00 <br />User_ sdt <br />Par—Laser Oilfield Services <br />1f., Check only rec'd. <br />Receipt Total: <br />$791.00 <br />RECEIVED <br />JUL 03 zurr <br />' <br />lormd a�iG�MIS SIO OF RECLAMATION, <br />SAFETY -MINERALS <br />S <br />Page 1 of 1 <br />