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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2OO5065 <br /> Jack Clark, Jr. Receipt#: 35472 <br /> Jack Clark Jr Date: 06/30/2021 <br /> P. O. Box 767 <br /> Permit: M2005065 <br /> Silverton CO 814330000 <br /> MethodPayment Revenue Code Fee Description/Notes Amount <br /> Check#1001 4300-MTRO Minerals Technical Revision $216.00 <br /> User: SDT <br /> Payer: Animas Aggregate Supply LLC <br /> TR02 <br /> Receipt Total: $216.00 <br /> Page 1 of 1 <br />