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Daniel A Lewis <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for P2013007 <br />Receipt #: 15012 <br />Date: 04/16/2013 <br />Permit: P2013007 <br />Payment Method Revenue Code Fee Description /Notes <br />ount <br />4268 <br />4300 -10 <br />Minerals Prospecting Application Fee /NOI <br />P- 2013 -007, CMB <br />$86.00 <br />Receipt Total: I $86.00 <br />Page 1 of 1 <br />