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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2009074 <br />Receipt #: <br />Date: <br />Permit: <br />6547 <br />09/11/2009 <br />M2009074 <br />Colorado Backhole Service <br />000000000 <br />4182 14300-02 1 Minerals Application Fees <br />M-2009-074 <br />$1,258.00 <br />Receipt Total: $1,258.00 <br />Page 1 of 1