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George E. Often r <br />000000000 <br />41) <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1984O13 <br />Receipt #: 11604 <br />✓iSate: 10/13/2011 <br />Permit: M1984013 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />1241 <br />4300 -01 <br />inerals Annual Fees <br />M- 1984 -013 <br />$259.00 <br />Receipt Total: I $259.00 <br />Page 1 of 1 <br />