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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1985140 <br />Estate of David Goss <br />000000000 <br />6942 SMS 14300-01 1 Minerals Annual Fees <br />M1985 -140 Paid By Dean & Audra Goss <br />Receipt #: <br />Date: <br />Permit <br />16933 <br />02/26/2014 <br />M1985140 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />