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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1983030 <br />Receipt #: <br />Date: <br />Permit: <br />10684 <br />06/02/2011 <br />M1983030 <br />Westley Potts <br />000000000 <br />7468-mr1 4300-01 Minerals Annual Fees <br />M-1983-030 <br />$86.00 <br />Receipt Total: $86.00 <br />Page 1 of 1