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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M2001012 <br />Receipt #: <br />Date: <br />8148 <br />Washington County <br />Permit: <br />000000000 <br />55160 14300-01 1 Minerals Annual Fees <br />M-2001-012 <br />05/13/2010 <br />M2001012 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1