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Kiowa County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1991073 <br />111111111 <br />Receipt #: 5848 <br />Date: 06/15/2009 <br />Permit: M1991073 <br />Payment Methoci <br />nua Cod® _. <br />Fee Description/Notes <br />Amount <br />Minerals Annual Fees <br />991-073 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />