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Colorado Division of Minerals & Geology <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 <br />SOLD TO <br />MofTat County <br />Sales Receipt <br /> <br />DATE SALE NO. <br />10/6/2004 12973 <br /> CHECK#/CASH <br /> 47025 <br />DESCRIPTION NOTE AMOUNT <br />Min: Annual Fee M-2002-059 688.00 <br /> Total $6ss.oo <br />