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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978107 <br />Montezuma County <br />28672 SDT 14300-MAFO I Minerals Annual Fees <br />M1978-107 <br />Receipt #: <br />Date: <br />Permit: <br />20413 <br />10/15/2015 <br />M 1978107 <br />791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1