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Moffat County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1989112 <br />Receipt #: 15088 <br />Date: 04/25/2013 <br />Permit: M1989112 <br />Payment Method Revenue Code <br />Fee Description /Notes <br />Amount <br />32699 <br />4300 -11 <br />Minerals Technical Revision <br />M- 1989 -112, CMB <br />$2,696.00 <br />Receipt Total: I $2,696.00 I <br />Page 1 of 1 <br />