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Lafarge West, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2010058 <br />Receipt #: 13775 <br />Date: 09/25/2012 <br />Permit: M2010058 <br />•Payment Method Revenue Code Fee Description /Notes <br />Ai <br />count <br />73238186 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 2010 -058 <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />