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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1990116 <br />Phillips County <br />000000000 <br />21403 I 4300-01 I Minerals Annual Fees <br />M-1990-116 <br />Receipt #: <br />Date: <br />Permit: <br />9160 <br />10/07/2010 <br />M1990116 <br />$323.00 <br />Receipt Total: 1 $323.00 <br />Page 1 of 1