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General Shale Brick, Inc. <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978009 <br />111111111 <br />Receipt #: 19999 <br />Date: 08/04/2015 <br />Permit: M1978009 <br />Ment Method <br />Revenue Code <br />Fee Description/Notes <br />11:• 1: <br />11 1Minerals <br />Annual Fees• <br />M1978-009 <br />11 <br />Receipt Total: 11 $791.00 <br />Page 1 of 1 <br />