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Park County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1986140 <br />019131 SMS 1 4300 -01 1 Minerals Annual Fees <br />M1986 -140 <br />Receipt # <br />Date <br />Permit: <br />17130 <br />04/02/2014 <br />fiiliMO.101 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1 <br />