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Colorado Division of Highways <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1979111 <br />Receipt #: 13710 <br />Date: 09/19/2012 <br />Permit: M1979111 <br />Payment Method ` Revenue Code <br />Fee Description /Notes Amount <br />010332 <br />4300 -09 <br />Minerals Succession of Operators <br />M- 1979 -111, CMB <br />$144.00 <br />Receipt Total: I $144.00 <br />Page 1 of 1 <br />