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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978221 <br />#17 Enterprises, LLC <br />Scott Stewart <br />0275 CR 22 <br />P.O. Box 88 <br />DeBeque CO 816300000 <br />Receipt #: <br />Date: <br />Permit: <br />37309 <br />12/16/2021 <br />M1978221 <br />MethodPayment Revenue Code• •Amount <br />Check #1144 5700 Minerals Civil Penalty/Violation Fines $323.00 <br />User: AHD <br />Payer: #10 Enterprises LLC <br />CV-2021-023 <br />Receipt Total: $323.00 <br />Page 1 of 1 <br />