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Rio Blanco County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004038 <br />Receipt #: 14470 <br />Date: 01/17/2013 <br />Permit: M2004038 <br />pa nt <br />) es <br />ev nue w Co <br />dN t` <br />0 <br />137359 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2004 -038, CMB <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />