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Moffat County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1980239 <br />Receipt #: 14241 <br />Date: 12/11/2012 <br />Permit: M1980239 <br />Pay <br />l eti od <br />Revenue Code <br />Description /Notes <br />â–ºsou <br />325149 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1980 -239, CMB <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />