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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977322 <br />Summit Brick & Tile Co. <br />000000000 <br />Receipt #: <br />Date: <br />Permit: <br />20959 <br />02/12/2016 <br />M1977322 <br />125433 SDT <br />4300-MAFO <br />Minerals Annual Fees <br />$323.00 <br />M1977-322 <br />Receipt Total: $323.00 <br />Page 1 of 1 <br />