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Montrose County <br />000000000 l <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2011005 <br />Receipt #: 15112 <br />Date: 04/29/2013 <br />Permit: M2011005 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />374519 <br />4300 -01 <br />Minerals Annual Fees <br />M- 2011 -005, cmb <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />