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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1983011 <br />Jelen & Son, Inc. <br />000000000 <br />11884-mr1 14300-01 1 Minerals Annual Fees <br />M-1983-011, fees paid by Design West, LLC <br />Receipt #: <br />Date: <br />Permit: <br />Receipt Total: <br />4997 <br />02/24/2009 <br />M1983011 <br />$259.00 <br />$259.00 <br />Page 1 of 1