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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004052 <br />Phillips County <br />000000000 <br />Receipt #: 3771 <br />Date: 08/14/2008 <br />Permit: M2004052 <br />PwcnCi o o L°3c onn W o loo D@@@A(K O- -V pac-@3 /A m <br />15861 4300-01 Minerals Annual Fees <br />M-2004-052 $323.00 <br /> <br /> Receipt Total: $323.00 <br />Page 1 of 1