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Mountain Region Corporation <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1995005 <br />Receipt #: 19052 <br />Date: 03/02/2015 <br />Permit: M1995005 <br />12969 msr I 4300 -MAFO I Minerals Annual Fees 1 $791.00 <br />M 199 -005 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />