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General Shale Brick, Inc. <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1979221 <br />111111111 <br />Receipt #: 20002 <br />Date: 08/04/2015 <br />Permit: M1979221 <br />yment Meth9g, <br />Revenue Coon <br />ee Description/Notes <br />Amount <br />11:9 <br />11 1Minerals <br />Annual Fees• <br />.. -221 <br />11 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />