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Nick H. Gray <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2005012 <br />Receipt #: 14326 <br />Date: 12/26/2012 <br />Permit: M2005012 <br />Payment Method ; Revenue Code LL fee Description /Notes <br />Amount <br />CMB, 3076 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2005 -012 PAID BY ROCKY MTN AGGREGATE <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />