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GN <br />Frank Gilmore <br />000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1983209 <br />A hn .t ( 1-e e- <br />Receipt #: / 10998 <br />Date: ✓ 07/20/2011 <br />Permit: M1983209 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />8165 -mr1 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1983 -209 <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />