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Seifert Construction <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1991083 <br />Receipt #: 13809 <br />Date: /01 /2012 <br />Permit: M1991083 <br />Payment Method Revenue Code Descrt tlon/Notes <br />Amou <br />1293 jwd <br />4300 -01 <br />Minerals Annual Fees <br />M- 1991 -083, Paid By Seifert Enterprises LLC <br />$791.00 <br />Receipt Total: I $791.00 <br />Page 1 of 1 <br />