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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1984101 <br />Hard Rock Paving and Redi -Mix, Inc. <br />000000000 <br />28757 jwd 4300 -01 1 Minerals Annual Fees <br />M- 1984 -101 <br />Receipt #: 15940 <br />Date: 09/11/2013 <br />Permit: M1984101 <br />$791.00 <br />Receipt Total: 1 $791.001 <br />Page 1 of 1 <br />