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M J Cadgene <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1983158 <br />Receipt #: 11969 <br />Date: 12/19/2011 <br />Permit: M1983158 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />4088 kja <br />4300 -01 <br />Minerals Annual Fees <br />M1983-158 <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />