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Larry Mondragon <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2002106 <br />1111TIllis I 1=1 81 <br />10123 SDT 14300-MAFO I Minerals Annual Fees <br />M2002-106 <br />Receipt # <br />Date <br />Permit: <br />20220 <br />09/09/2015 <br />M2002106 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />