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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for MI975009 <br /> The Lakewood Brick and Tile Company Receipt#: 25239 <br /> Thomas Murray Date: 09/20/2017 <br /> 1325 Jay St <br /> Permit: M1975009 <br /> Lakewood CO 802140000 <br /> MethodPayment Revenue CodeDescription/Notes <br /> Check#139266 4300-MAFO Minerals Annual Fees $323.00 <br /> User: MSR <br /> Payer: Summit Brick Company <br /> 2017 <br /> Receipt Total: $323.00 <br /> Page 1 of 1 <br />