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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977567 <br />Receipt #: <br />Date: <br />9622 <br />Saguache County <br />Permit: <br />000000000 <br />53603 14300-01 1 Minerals Annual Fees <br />M-1977-567 <br />12/30/2010 <br />M1977567 <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1