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General Shale Brick, Inc. <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977251 <br />Receipt #: 16939 <br />Date: 02/27/2014 <br />Permit: M1977251 <br />Method Payment <br />Revenue Code <br />00854391 SMS <br />4300 -01 <br />Minerals Annual Fees <br />M1977-251 <br />$791.00 <br />Receipt Total: <br />$791.00 <br />Page 1 of 1 <br />