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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1977251 <br /> General Shale Brick, Inc. Receipt#: 23053 <br /> Tony Fabrizio Date: 03/06/2017 <br /> 1845 W. Dartmouth Ave. <br /> Permit: M1977251 <br /> Denver CO 801101308 <br /> Payment Method Revenue Code Fee Description/Paid By Other Entity/Notes Amount <br /> Check#0093579f 4300-MAFO Minerals Annual Fees $791.00 <br /> General Shale <br /> Due 03/05/17 <br /> Receipt Total: $791.00 <br /> Page 1 of 1 <br />