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Weld County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1980121 <br />Receipt #: 14709 <br />Date: 02/26/2013 <br />Permit: M1980121 <br />Payment Method Revenue Code <br />Fee <br />Description/Notes <br />Amount <br />3281799 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 1980 -121 <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />