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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004038 <br />Rio Blanco County <br />000000000 <br />125871-mr1 I 4300-01 I Minerals Annual Fees <br />M-2004-038 <br />Receipt #: <br />Date: <br />Permit: <br />4663 <br />01/15/2009 <br />M2004038 <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1