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Fruita Development LLC <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2002111 <br />Receipt #: 13927 <br />Date: 10/15/2012 <br />Permit: M2002111 <br />Payment Method Revenue Feet' D es ptian /Note <br />oun <br />3865 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2002 -111, CMB <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />