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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2002113 <br />Receipt #: <br />Date: <br />6634 <br />Adams County RV Park, LLC dba 124th Estate <br />Permit: <br />000000000 <br />1305 1 4300-03 1 Minerals Amendment Fees <br />M-2002-113, Paid By Les Ewegen LLC <br />09/23/2009 <br />M2002113 <br />$2,229.00 <br />Receipt Total: 1 $2,229.00 <br />Page 1 of 1