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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1984041 <br />American Gypsum Company LLC <br />Receipt #: 16523 <br />Date: 12/16/2013 <br />Permit: M1984041 <br />Method Payment <br />Revenue Code <br />00260549 <br />4300 -01 <br />Minerals Annual Fees <br />M 1984 -041 <br />$791.00 <br />Receipt Total: <br />$791.00 <br />Page 1 of 1 <br />