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Everist Materials, LLC <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1996049 <br />Receipt #: 14208 <br />Date: 12/04/2012 <br />Permit: M1996049 <br />Payment Revenue Code <br />Fee l Descrip ioi /Notes ' Amount <br />028513 jwd <br />4300 -01 <br />inerals Annual Fees <br />M- 1996 -049 <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />