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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1991080 <br />Russ Van Egmond <br />Receipt #: <br />Date: <br />6884 <br />000000000 <br />9712 14300-01 1 Minerals Annual Fees <br />M-1991-080, Paid By Van Egmond Services, Inc. <br />Permit: <br />10/21/2009 <br />M1991080 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1