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Las Animas County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1979163 <br />Receipt #: 14713 <br />Date: 02/28/2013 <br />Permit: M1979163 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />020409 <br />4300 -04 <br />Minerals Conversions <br />M- 1979 -163, CMB <br />$2,696.00 <br />Receipt Total: I $2,696.00 I <br />Page 1 of 1 <br />