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Grand County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1995004 <br />Receipt #: 12845 <br />Date: 05/02/2012 <br />Permit: M1995004 <br />Payment <br />ethod <br />Revenue Code <br />Fee Description /Notes Amount <br />53099 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1995 -004, CMB <br />Receipt Total: <br />$791.00 <br />$791.00 I <br />Page 1 of 1 <br />