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A. Blassi & Son Trucking & Earthmoving, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2002109 <br />Receipt #: 14084 <br />Date: 11/13/2012 <br />Permit: M2002109 <br />ent <br />Fe <br />co <br />A i <br />L Pay r <br />ethod Revenue Code <br />escrip <br />Note <br />53030 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2002 -109, CMB <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />