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-fro <br />Sutherland Brothers, Inc. ,F <br />000000000 <br />-- FA FEE a <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1 J96031 <br />4'0 z <br />Receipt #: 13541 <br />',Prate: 08/20/2012 <br />Permit: M1996031 <br />Payment Method Revenue Code Fed Desc ptionl otes <br />c ount <br />16821 jwd <br />4300 -11 <br />Minerals Technical Revision <br />M- 1996 -031 <br />$216.00 <br />Receipt Total: I $216.00 <br />Page 1 of 1 <br />