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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1983164 <br />j"George F. Gallegos <br />000000000 <br />5729-mr1 I 4300-01 I Minerals Annual Fees <br />M-1983-164 <br />Receipt #: <br />Date: <br />Permit: <br />8758 <br />08/05/2010 <br />M1983164 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1