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Camp Bird Colorado, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1982090 <br />Receipt #: 13520 <br />Date: 08/15/2012 <br />Permit: M1982090 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />1174 <br />4300 -11 <br />Minerals Technical Revision <br />M- 1982 -090, PAID BY REARDON <br />$175.00 <br />Receipt Total: I $175.00 <br />Page 1 of 1 <br />