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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977140 <br />Mathias Concrete, Inc. <br />Receipt #: <br />Date: <br />Permit: <br />5503 <br />04/28/2009 <br />M1977140 <br />000000000 <br />9609-mr1 14300-11 1 Minerals Technical Revision <br />M-1977-140 fees paid by Mathias Concrete, Inc. <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1