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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2000110 <br />Mario Bassi and Josephine Bassi <br />000000000 <br />Receipt # <br />Date <br />Permit <br />20259 <br />09/17/2015 <br />M2000110 <br />1083 SDT 4300-MAFO I Minerals Annual Fees 1 $791.00 <br />M2000-110 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />