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Belvedere Stone, LLC <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1991147 <br />1020 14300-01 1 Minerals Annual Fees <br />M- 1991 -147, CMB <br />Receipt #: <br />Date: <br />Permit: <br />15610 <br />07/17/2013 <br />M1991147 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />