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Thomas F & Ginger L Latham <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981058 <br />14639 14300-01 1 Minerals Annual Fees <br />M- 1981 -058, CMB <br />Receipt #: <br />Date: <br />Permit: <br />15919 <br />09/05/2013 <br />M1981058 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />