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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1986040 <br />Bear River Sand and Gravel, LLC <br />000000000 <br />Payment Method f Revenue Code <br />1001 msr <br />4300-MTRO <br />Receipt #: <br />Date: <br />Permit: <br />20504 <br />10/28/2015 <br />M1986040 <br />Minerals Technical Revision <br />M1986-040 paid by Bear River Land LLC <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1 <br />