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Y 0"ZI(d ju <br /> Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M2009093&. <br /> 11 Theisen Mineral Receipt#: 17729 <br /> Date: 07/01/2014 <br /> Permit: M2009093 <br /> 000000000 <br /> 8303 msr 4300-MAFO Minerals Annual Fees $323.00 <br /> M2009-093 paid by James J OR Suzanne M. Theisen <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />