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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004009 <br />Asphalt Specialties Co., Inc. <br />000000000 <br />Receipt #: <br />20073 <br />Date: <br />08/12/2015 <br />Permit: <br />M2004009 <br />033252 SDT <br />4300-MAFO <br />Minerals Annual Fees <br />$791.00 <br />M2004-009 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />