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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004025 <br />Farnsworth Construction and Gravel Compan <br />11613 SMS 1 4300 -01 1 Minerals Annual Fees <br />M2004 -025 <br />Receipt #: <br />Date: <br />Permit: <br />17251 <br />04/21/2014 <br />M2004025 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />