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T Bone Stone, Inc. <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004030 <br />4347 jwd 4300 -01 1 Minerals Annual Fees <br />M- 2004 -030 <br />Receipt #: <br />Date: <br />Permit: <br />15978 <br />09/16/2013 <br />M2004030 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />