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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1987074 <br /> Mayne Block&Stone Company Receipt#: 25356 <br /> Joseph Welte Date: 10/11/2017 <br /> P.O. Box 533 <br /> Permit: M1987074 <br /> Pueblo CO 810020000 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#139678 4300-MAFO Minerals Annual Fees $791.00 <br /> User: MSR <br /> Payer: Summit Brick Company <br /> 2017 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />