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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1981148 <br />General Shale Brick, Inc. <br />Harold Stickler <br />1845 W Dartmouth Ave <br />Denver CO 801101308 <br />Receipt #: <br />Date: <br />Permit: <br />25488 <br />11/03/2017 <br />M1981148 <br />Page 1 of 1 <br />Check #00950880 <br />4300-MAFO <br />Minerals Annual Fees <br />$791.00 <br />User: sdt <br />Payer: General Shale <br />Due 111117 <br />Receipt Total: <br />$791.00 <br />Page 1 of 1 <br />