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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978192 <br />Chaffee County <br />Receipt #: 19609 <br />Date: 05/28/2015 <br />Permit: M1978192 <br />141418 msr <br />4300-MAFO <br />Minerals Annual Fees <br />$323.00 <br />M 1978-192 <br />Receipt Total: $323.00 <br />Page 1 of 1 <br />