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Phillips County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004052 <br />29558 1 4300 -01 1 Minerals Annual Fees <br />m2004O52 kja <br />Receipt #: <br />Date: <br />Permit: <br />16138 <br />10/08/2013 <br />M2004052 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />