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David J. Larsen <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978140 <br />Receipt #: 11660 <br />Date: 10/21/2011 <br />Permit: M1978140 <br />Payment Method Revenue Code <br />Fee Description /Notes Amount <br />1647 <br />4300 -09 <br />Minerals Succession of Operators <br />M- 1978 -140, Paid By Julie M. Mikulas <br />I <br />$144.00 <br />Receipt Total: I $144.00 <br />Page 1 of 1 <br />