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Lost Cause, LLC <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2010084 <br />111111111 <br />Receipt #: 19529 <br />Date: 05/14/2015 <br />Permit: M2010084 <br />Receipt Total: T $323.00 <br />Page 1 of 1 <br />1014 msr <br />4300-MAFO <br />Minerals Annual Fees <br />M2010-084 paid by Tim Mantle <br />$323.00 <br />Receipt Total: T $323.00 <br />Page 1 of 1 <br />