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Robert Daugherty <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004048 <br />Receipt #: 16236 <br />Date: 10/22/2013 <br />Permit: M2004048 <br />Payment Meth, <br />RevenuCode <br />Description /Notes <br />. <br />W I <br />Minerals Annual Fees <br />M-2004-048 <br />Receipt Total: $323.00 <br />Page 1 of 1 <br />