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Wallace F. Burtis <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2001070 <br />[IIIIIIIIIIIII 11 <br />Receipt #: 20098 <br />Date: 08/17/2015 <br />Permit: M2001070 <br />Pyment Nod <br />Revenue Code <br />„ Fee Description/Notes <br />Amount " ` `" <br />Minerals Annual Fees <br />M2001-070 <br />Receipt Total: 1 $259.00 <br />Page 1 of 1 <br />