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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1999069 <br />Jake Kauffman & Son, Inc <br />Receipt #: <br />Date: <br />Permit: <br />8654 <br />07/23/2010 <br />M1999069 <br />000000000 <br />9381 14300-11 1 Minerals Technical Revision <br />M-1999-069, Paid By Olga or Daniel P. Giroux <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1