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Sedgwick County <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1996073 <br />Receipt #: 11686 <br />Date: 10/27/2011 <br />Permit: M1996073 <br />Payment Method <br />Revenue Code,; Fee Description/Notes Amount <br />69509 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1996 -073 <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />