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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1978011 <br /> General Shale Brick, Inc. Receipt#: 17941 <br /> Date: 08/04/2014 <br /> Permit: M1978011 <br /> 000000000 <br /> MethodPayment Revenue Code le tion/Notes AM Amount <br /> 00866728 msr 4300-MAFO Minerals Annual Fees $791.00 <br /> M1978-011 paid by General Shale <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />