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Ignacio Vasquez Sr <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2000089 <br />Receipt #: 13795 <br />Date: 09/28/2012 <br />Permit: M2000089 <br />Payment Method <br />nue <br />Lies <br />niNotes t n <br />115 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2000 -089, CMB <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />