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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1986123 <br />Coulson Excavating Co, Inc. <br />000000000 <br />Receipt #: <br />Date: <br />Permit: <br />6858 <br />10/19/2009 <br />M1986123 <br />35253 <br />4300-01 <br />Minerals Annual Fees $791.00 <br />M-1986-123 <br />Receipt Total: $791.00 <br />Page 1 of 1