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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977479 <br />Baca County <br />Receipt #: <br />Date: <br />Permit: <br />9738 <br />01/18/2011 <br />M1977479 <br />000000000 <br />25188 14300-11 1 Minerals Technical Revision <br />M-1977-479 <br />$216.00 <br />Receipt Total: $216.00 <br />Page 1 of 1