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White Sand & Gravel, LLC <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2010062 <br />Receipt #: 14423 <br />Date: 01/11/2013 <br />Permit: M2010062 <br />Payment Method Revenue Code '` <br />Fee Description /Notes § Amount <br />4099 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 2010 -062, Paid By White Ranch <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />