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Park County <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1986140 <br />015469 1 4300 -01 1 Minerals Annual Fees <br />M- 1986 -140, CMB <br />Receipt #: <br />Date: <br />Permit: <br />15078 <br />04/25/2013 <br />M1986140 <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1 <br />