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RECEIVED <br /> SEP 2 62017 <br /> DIVISION ')F RECLAMATION, Division of Reclamation, Mining, and Safety <br /> M�W SAFETY-MINERALSFee Receipt for M2013056 <br /> Richard Fretterd Receipt#: 25266 <br /> Richard Fretterd Date: 09/26/2017 <br /> 1065 Woodland Ave, #16 <br /> Permit: M2013056 <br /> Woodland Park CO 808630000 <br /> MethodPayment Revenue CodeDescription/Notes <br /> Check#1214 4300-MAFO Minerals Annual Fees $201.00 <br /> User: MSR <br /> Payer: Legacy Gems and Minerals LLC <br /> 2017 readjusted per ERR <br /> Receipt Total: $201.00 <br /> Page 1 of 1 <br />