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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2005065 <br />Jack Clark Jr. <br />000000000 <br />Receipt #: <br />Date: <br />Permit: <br />7025 <br />11/16/2009 <br />1273-mr1 4300-01 1 Minerals Annual Fees <br />M-2005-065, fees paid by Upper Animas Rock Products LLP <br />M2005065 <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1