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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2003024 <br />Phillips County <br />Receipt #: <br />Date: <br />5791 <br />06/08/2009 <br />M2003024 <br />Permit: <br />000000000 <br />17332 1 4300-04 1 Minerals Conversions <br />M-2003-024 <br />$2,696.00 <br />Receipt Total: $2,696.00 <br />Page 1 of 1