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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1997086 <br />Siloam Stone, Inc. <br />000000000 <br />15045 SMS 1 4300 -01 1 Minerals Annual Fees <br />M 1997 -086 <br />Receipt #: <br />Date: <br />Permit: <br />17026 <br />03/18/2014 <br />M1997086 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />