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Valco Canon City Concrete Div. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977559 <br />Receipt #: 13596 <br />Date: 08/29/2012 <br />Permit: M1977559 <br />Payment Method Revenue Code <br />Fee Description /Notes <br />Count' <br />28240 jwd <br />4300 -11 <br />Minerals Technical Revision <br />M- 1977 -559 <br />$216.00 <br />Receipt Total: I $216.00 <br />Page 1 of 1 <br />