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Pete Lien & Sons, Inc. <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004013 <br />Receipt #: 14914 <br />Date: 04/01/2013 <br />Permit: M2004013 <br />Payment Method Revenue Code <br />Fee DescriptionlNotes <br />Amount <br />210625 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 2004 -013 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />