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David Goss <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1985140 <br />19111I1I1I111 <br />7027 msr 1 4300 -MAFO I Minerals Annual Fees <br />M1985 -140 paid by Dean and Audra Goss <br />Receipt #: <br />Date: <br />Permit: <br />18744 <br />01/07/2015 <br />M1985140 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />