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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1991086 <br />01 <br />Bent County <br />Receipt #: <br />Date: <br />Permit: <br />8208 <br />05/21/2010 <br />M1991086 <br />000000000 <br />20347 1 4300-11 1 Minerals Technical Revision <br />M-1991-086 <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1