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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981058 <br />Thomas F & Ginger L Latham <br />Receipt #: <br />Date: <br />Permit: <br />4749 <br />01/21/2009 <br />M1981058 <br />000000000 <br />052137-mr1 14300-11 1 Minerals Technical Revision <br />M-1981-058, fee paid by Kirkland Construction LLLP <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1