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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004043 <br />Universal Landscape & Aggregate Supply, Inc <br />Receipt #: 16222 <br />Date: 10/22/2013 <br />Permit: M2004043 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />6129 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 2004 -043, Paid By Universl Inc. <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />