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Rock -N -Pine LLC <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2003074 <br />Receipt #: 14761 <br />Date: 03/05/2013 <br />Permit: M2003074 <br />Payment Method Revenue Code Fee Description /Notes Amount <br />Cash <br />4300 -01 <br />Minerals Annual Fees <br />M- 2003 -074, Paid By Todd Sullivan <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />