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Pine Bluffs Gravel & Excavating, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2013018 <br />Receipt #: 14817 <br />Date: 03/19/2013 <br />Permit: M2013018 <br />Payment Method Revenue Code <br />Fee Description /Notes <br />Amount <br />1954 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2013 -018, CMB <br />Receipt Total: 1 <br />$1,258.00 <br />$1,258.001 <br />Page 1 of 1 <br />