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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1979221 <br /> General Shale Brick, Inc. Receipt#: 22054 <br /> Tony Fabrizio Date: 08/24/2016 <br /> 1845 W. Dartmouth Ave. <br /> Permit: M1979221 <br /> Denver CO 801101308 <br /> MethodPayment Revenue Code • • • Amount <br /> Check#0092155: 4300-MAFO Minerals Annual Fees $791.00 <br /> 2016 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />