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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977140 <br />Mathias Concrete Inc <br />000000000 <br />Receipt #: <br />Date: <br />Permit: <br />16561 <br />12/20/2013 <br />M1977140 <br />Page 1 of 1 <br />12456 msr <br />4300 -01 <br />Minerals Annual Fees <br />M1977 -140 <br />$791.00 <br />Receipt Total: <br />$791.00 <br />Page 1 of 1 <br />