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City of Lamar <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1984154 <br />Receipt #: 14205 <br />Date: 12/03/2012 <br />Permit: M1984154 <br />P ayment Method Revenue Code <br />Fee Description /Notes Amount <br />64772 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1984 -154, CMB <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />