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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977479 <br />01 <br />Baca County <br />Receipt #: <br />Date: <br />Permit: <br />6509 <br />09/03/2009 <br />M1977479 <br />000000000 <br />95592 4300-01 Minerals Annual Fees $791.00 <br />M-1977-479 <br />Receipt Total: $791.00 <br />Page 1 of 1