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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1982154 <br />Farnsworth Construction and Gravel Compan <br />Receipt #: <br />Date: <br />Permit: <br />6920 <br />10/28/2009 <br />M1982154 <br />000000000 <br />9111-mr1 14300-01 1 Minerals Annual Fees <br />M-1982-154, fees paid by Farnsworth Construction Co. <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1