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Jefferson County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977245 <br />Receipt #: 14988 <br />Date: 04/11/2013 <br />Permit: M1977245 <br />Payment Method Revenue Code Fee Description /Notes Amount <br />597378 jwd <br />4300 -11 <br />Minerals Technical Revision <br />M- 1977 -245 <br />$216.00 <br />Receipt Total: I $216.00 <br />Page 1 of 1 <br />