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Haldorson and Sons, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1995038 <br />Receipt #: 14043 <br />Date: 11/05/2012 <br />Permit: M1995038 <br />Payment Method ; Revenue Code <br />Fee Description /Notes <br />A <br />ount <br />7152 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 1995 -038 <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />