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Puckett Land Company <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2012016 <br />Receipt #: 12782 <br />Date: 04/24/2012 <br />Permit: M2012016 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />57990 <br />4300 -02 <br />Minerals Application Fees <br />M- 2012 -016, CMB <br />$898.00 <br />Receipt Total: I $898.00 <br />Page 1 of 1 <br />