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Donald G. Popejoy <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1986124 <br />Receipt #: 13875 <br />Date: 10/10/2012 <br />Permit: M1986124 <br />Payment Method Revenue Code <br />Fee Description /Notes <br />Ai <br />ount <br />3448 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1986 -124, CMB <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />