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L.G. Everist, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2001017 <br />Receipt #: 13726 <br />Date: 09/20/2012 <br />Permit: M2001017 <br />Payment Method Revenue Code <br />Description /Notes <br />At <br />aunt <br />179559 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 2001 -017 <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />