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GSL /Brush LLC <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2001085 <br />Receipt #: 14163 <br />Date: 11/26/2012 <br />Permit: M2001085 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />2041 jwd <br />4300 -03 <br />Minerals Amendment Fees <br />M- 2001 -085, Paid By 120 85 LLC- Balance Due <br />$291.00 <br />Receipt Total: I $291.00 <br />Page 1 of 1 <br />