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General Shale Brick, Inc. <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978014 <br />/11111111 <br />Receipt #: 20001 <br />Date: 08/04/2015 <br />Permit: M1978014 <br />I?ment Method <br />Revenue Codee <br />Description/Notes <br />Amount <br />00895210 SDT <br />Minerals-- <br />M1978-014 <br />• 11 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />