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Asphalt Constructors, Inc. <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2001069 <br />11111111111111WO <br />O <br />Receipt #: 20463 <br />Date: 10/20/2015 <br />Permit: M2001069 <br />Payment Method <br />Revenue Code <br />Fee Description/Notes <br />Amount <br />I <br />M2001-069 <br />• �� <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />