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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2009064 <br />Grand County <br />000000000 <br />NI <br />Receipt #: 16481 <br />Date: 12/06/2013 <br />Permit: M2009064 <br />.1 <br />:_ II <br />061175 msr <br />4300 -01 <br />Minerals Annual Fees <br />M2009 -064 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />