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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2003016 <br /> City and County of Broomfield Receipt#: 40438 <br /> Brennan Middleton Date: 03/06/2023 <br /> 3951 West 144th Avenue <br /> Permit: M2003016 <br /> Broomfield CO 800230000 <br /> Payment . • Revenue Code • • <br /> Check#1097 4300-MTRO Minerals Technical Revision $216.00 <br /> User: AHD <br /> Payer: Civil Resources LLC <br /> TR-6 <br /> Receipt Total: $216.00 <br /> Page 1 of 1 <br />