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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1995008 <br />Fremont Paving & Redi -Mix, Inc. <br />000000000 <br />Receipt #: <br />Date: <br />Permit: <br />15414 <br />06/18/2013 <br />M1995008 <br />Method Payment <br />Revenue Code <br />84444 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1995 -008, CMB <br />$791.00 <br />Receipt Total: <br />$791.00 <br />Page 1 of 1 <br />