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Dale nad Ellen Schmidt <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2011014 <br />Receipt #: 11696 <br />Date: 10/31/2011 <br />Permit: M2011014 <br />Payment Method Revenue Code <br />Fee Description /Notes <br />mou <br />19264274537 -mr <br />19264274548 -mr <br />4300 -02 <br />4300 -02 <br />Minerals Application Fees <br />M- 2011 -014 <br />Minerals Application Fees <br />M- 2011 -014 <br />$1,000.00 <br />$258.00 <br />Receipt Total: I $1,258.00 <br />Page 1 of 1 <br />