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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2013018 <br />Pine Bluffs Gravel & Excavating, Inc. <br />111111111 <br />Receipt #: <br />Date: <br />Permit: <br />19819 <br />07/01/2015 <br />M2013018 <br />Payment Method <br />Revenue Code <br />Fee Description/Notes <br />Amount <br />.1 <br />11 1Minerals <br />Annual Fees• <br />M2013-018 <br />11 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />