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Toeroek Associates, Inc. <br />300 Union Blvd., Ste. 520 <br />Laskewood <br />CO 802280000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for Minerals <br />Receipt #: 14519 <br />Date: 01/28/2013 <br />Permit: Minerals <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />2425 jwd <br />4400 <br />Mineral Copies <br />M- 1977 -378, DVD <br />$20.00 <br />Receipt Total: I $20.00 <br />Page 1 of 1 <br />