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Hardrock Sand & Gravel <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977443 <br />Receipt #: 14154 <br />Date: 11/23/2012 <br />Permit: M1977443 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />2152 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 1977 -443 <br />Receipt Total: <br />$323.00 <br />$323.00 I <br />Page 1 of 1 <br />