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San Miguel County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1989030 <br />Receipt #: 15113 <br />Date: 04/29/2013 <br />Permit: M1989030 <br />Paymen <br />Me <br />hod Revenue Code <br />Fee Description /Notes Amount <br />72557 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1989 -030, CMB <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />