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Division of Reclamation, Mining, and Safety <br />Fee Receipt for Minerals <br />Larissa Ellis/Ryan Ellis <br />7825 Crest Drive <br />Lakewood CO 802140000 <br />Receipt #: <br />Date: <br />Permit: <br />7680 <br />03/03/2010 <br />Minerals <br />1328 I 4400 I Mineral Copies <br />M-1997-027 M-2009-024 M-2009-062- CD's <br />$15.00 <br />Receipt Total: $15.00 <br />Page 1 of 1