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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2000040 <br />Receipt #: <br />Date: <br />Permit: <br />8563 <br />07/09/2010 <br />M2000040 <br />Medicine Bow - Routt National Forest USDA F1 <br />000000000 <br />1091-mr1 4300-01 Minerals Annual Fees <br />M-2000-040, fees paid by Dawn A Hull <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1