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Mountain Region Corporation <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1995005 <br />Receipt #: 14618 <br />Date: 02/13/2013 <br />Permit: M1995005 <br />I O U <br />Ment <br />eth <br />even <br />12899 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 1995 -005 <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />