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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004025 <br />Farnsworth Construction & Gravel Co. <br />Receipt #: <br />Date: <br />Permit: <br />2993 <br />04/23/2008 <br />M2004025 <br />000000000 <br />7121 14300-11 I Minerals Technical Revision <br />M-2004-025, fees paid by Farnsworth Construction Co. <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1 <br />