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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1986123 <br />Coulson Excavating Company, Inc. <br />000000000 <br />Receipt #: <br />Date: <br />Permit: <br />16241 <br />10/23/2013 <br />M1986123 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />43490 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 1986 -123 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />