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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M199O143 <br /> General Shale Brick, Inc. Receipt#: 23054 <br /> Anthony Fabrizio Date: 03/06/2017 <br /> 1845 W. Dartmouth Ave. <br /> Permit: M1990143 <br /> Denver CO 801101308 <br /> Payment Method Revenue Code Fee Description/Paid By Other Entity/Notes Amount <br /> Check#0093578! 4300-MAFO Minerals Annual Fees $323.00 <br /> General Shale <br /> Due 03/14/17 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />