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Hector Rodriguez <br />000000000 <br />Division of Reclamation, Mining, aSafety <br />Fee Receipt for M1999062 <br />Receipt #: 13508 <br />Date: 08/13/2012 <br />Permit: M1999062 <br />Payment Method Revenue Code <br />ee Description /Notes Amount <br />20674 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 1999 -062, Paid By Blue Mountain Stone Inc. <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />