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000000000 <br />J <br />Phillips Stone Company <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981075 <br />Receipt #: 12950 <br />Date: 05/21/2012 <br />Permit: M1981075 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />25718 jwd <br />4300 -11 <br />Minerals Technical Revision <br />M- 1981 -075 <br />$216.00 <br />Receipt Total: I $216.00 I <br />Page 1 of 1 <br />