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Mountain Park Concrete, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1998034 <br />Receipt #: 14839 <br />Date: 03/21/2013 <br />Permit: M1998034 <br />Payment Method Revenue Code Fee Description /Notes Amount <br />11535 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1998 -034, CMB <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />