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Luis M. Vasquez <br />000000000 <br />Division of Reclamation, Mining nd Safety <br />Fee Receipt for M1 99063 <br />Receipt #: 13509 <br />+B'ate: 08/13/2012 <br />Permit: M1999063 <br />Payment Method Revenue Code <br />Fee Description/Notes Amount <br />20674 jwd <br />4300 -01 <br />Minerals Annual Fees f <br />M- 1999 -063, Paid By Blue Mountain Stone Inc. <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />