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Bent County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2004057 <br />026475 msr 14300-01 1 Minerals Annual Fees <br />M2004 -057 <br />Receipt #: <br />Date: <br />Permit: <br />16731 <br />01/24/2014 <br />M2004057 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />