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Division of Reclamation, Mining, and Safety <br />Fee Receipt for MI 997066 <br />LJS, LLC <br />Jim Striggow <br />4717 Bay View Drive <br />Fort Collins CO 805260000 <br />Receipt #: <br />Date: <br />Permit: <br />25487 <br />11/03/2017 <br />M1997065 <br />Page 1 of 1 <br />Check #21354 <br />4300-MAFO <br />Minerals Annual Fees <br />User: sdt <br />Payer: Stone Wholesale, Inc_ <br />Due 10/22/17 <br />$791.00 <br />Receipt Total: <br />$791.00 <br />Page 1 of 1 <br />