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AZCO Construction, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004029 <br />Receipt #: 13742 <br />Date: 09/20/2012 <br />Permit: M2004029 <br />Payment Method <br />Revenue Code <br />Fee Description /Notes' <br />Amount <br />10656 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 2004 -029 <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />