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Gregory Larson <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2007012 <br />Receipt #: 13806 <br />Date: 10/01/2012 <br />Permit: M2007012 <br />venue Cod <br />Pa ye t Method R <br />ores <br />A <br />Descnptio <br />Cott <br />5687 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 2007 -012, Paid By Larson Farms, GP <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />