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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978210 <br />Weld County <br />Receipt #: <br />Date: <br />Permit: <br />10004 <br />02/25/2011 <br />M1978210 <br />000000000 <br />3261257 14300-01 1 Minerals Annual Fees <br />M-1978-210 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1