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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1999040 <br />Receipt #: <br />Date: <br />Permit: <br />10469 <br />Rio Blanco County <br />000000000 <br />132617-mr1 14300-01 1 Minerals Annual Fees <br />M-1999-040 <br />05/02/2011 <br />M1999040 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1