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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1984117 <br />Fremont County <br />000000000 <br />106016 msr 14300-01 1 Minerals Annual Fees <br />M1984 -117 <br />Receipt #: <br />Date: <br />Permit: <br />16635 <br />01/06/2014 <br />M1984117 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />