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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978107 <br />Receipt #: <br />Date: <br />Permit: <br />7828 <br />03/29/2010 <br />M1978107 <br />Montezuma County <br />000000000 <br />122889 14300-11 I Minerals Technical Revision <br />M-1978-107 <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1