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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2004021 <br /> Washington County Receipt#: 17657 <br /> Date: 06/19/2014 <br /> Permit: M2004021 <br /> 000000000 <br /> •l ..,t. a .� �, <br /> 67959 msr 4300-01 Minerals Annual Fees $791.00 <br /> M2004-021 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />