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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1997094 <br /> Receipt#: 25552 <br /> Siloam Stone, Inc. <br /> Ferd & Matt Mueller Date: 11/16/2017 <br /> 315 N. 7th St. Permit: M1997094 <br /> Canon City CO 812120000 <br /> - aYm—ent Method Re nu+�od0 wn E SFR Fee De ariPti6r1IN ias� mo rnt <br /> Check#17126 4300-MAFO Minerals Annual Fees $323.00 <br /> User: sdt <br /> Due 11/20/17 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />