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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1979221 <br />General Shale Brick, Inc. <br />870398 SDT 14300-MTRO I Minerals Technical Revision <br />M 1979-221 <br />Receipt #: <br />Date: <br />Permit: <br />19580 <br />05/21/2015 <br />M 1979221 <br />$216.00 <br />Receipt Total: 1 $216.00 <br />Page 1 of 1 <br />