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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1991081 <br />r <br />Sam Keeling <br />Receipt #: <br />Date: <br />9082 <br />09/27/2010 <br />M1991081 <br />Permit: <br />000000000 <br />8119 14300-01 1 Minerals Annual Fees <br />M-1991-081, Paid By Sam M. Keelingdba Keeling Construction <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1