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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1986102 <br />B - Mining Company <br />Collins Morehead LLC <br />P O Box 3055 <br />Telluride CO 814350000 <br />Receipt #: 19368 <br />Date: 04/21/2015 <br />Permit: M1986102 <br />MethodPayment <br />Revenue Code <br />2389bjc <br />4300-MSOO <br />Minerals Succession of Operators <br />M1986-102 B -Mining paid by Collins Morehead LLC <br />$144.00 <br />Receipt Total: I $144.00 <br />Collins Morehead LLC 2389 <br />Dan or Laurie Collins R / J /3�i/ >+ 23-2/1020 <br />DATE-ttt--- �-- <br />Po Box 3055 <br />o0 <br />Telluride CO 81435 <br />w ��M <br />TOTH�EfjO�R(�ER OF� ❑°" <br />DOLLARS D I— <br />0 <br />o US Bank <br />0 238 Colorado Ave <br />Telluride CO 81435 <br />MP <br />Page 1 of 1 <br />