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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1985140 <br />Receipt #: <br />Date: <br />4467 <br />David Goss <br />Permit: <br />000000000 <br />1051 14300-01 1 Minerals Annual Fees <br />M-1985-140, Paid By Walter D Goss/Dean Goss/Audra L Goss <br />12/08/2008 <br />M1985140 <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1