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Wallace F. Burtis <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2001070 <br />8737 SMS 1 4300 -MAFO I Minerals Annual Fees <br />M2001 -070 <br />Receipt #: 18004 <br />Date: 08/1312014 <br />Permit: M2001070 <br />$259.00 <br />Receipt Total: 1 $259.00 <br />Page 1 of 1 <br />