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Blue Mountain Stone <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981108 <br />Receipt #: 13507 <br />ate: 08/13/2012 <br />Permit: M1981108 <br />Fee Description/Notes <br />20674 jwd <br />4300 -01 <br />inerals Annual Fees <br />M- 1981 -108 <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />