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Division of Reclamation, Mining, and Safety <br />Fee Receipt for P2017010 <br />Randy Ross <br />Randy Ross <br />Rte 2 <br />Box 2886 <br />Piedmont MO 639570000 <br />Receipt #: <br />Date: <br />Permit: <br />23694 <br />06/22/2017 <br />P2017010 <br />I _ . I <br />- - -- - .. _ -- <br />Check #1648 4300-PNOI Minerals Prospecting Application Pee1NOI $8600 <br />User sdt <br />Payer Randy or Christine Ross <br />Receipt Total: $86.00 <br />Page 1 of 1 <br />