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General Shale Brick, Inc. <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1984076 <br />111111111 <br />00895211 msr 14300-MAFO I Minerals Annual Fees <br />M1984-076 <br />Receipt #: <br />Date: <br />Permit: <br />20030 <br />08/04/2015 <br />M1984076 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />