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Puckett Land Company <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2012016 <br />201596 14300-01 1 Minerals Annual Fees <br />M- 2012 -016, CMB <br />Receipt #: <br />Date: <br />Permit: <br />15531 <br />07/05/2013 <br />M2012016 <br />$504.00 <br />Receipt Total: 1 $504.00 <br />Page 1 of 1 <br />