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Glacier Peak Art, Gems & Minerals <br />000000000 J <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2002003 <br />Receipt #: 12547 <br />Date: 03/20/2012 <br />Permit: M2002003 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />1371 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2002 -003, CMB <br />$259.00 <br />Receipt Total: I $259.00 I <br />Page 1 of 1 <br />