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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977252 <br />General Shale Brick, Inc. <br />Tony Fabrizio <br />1845 W. Dartmouth Ave_ <br />Denver CO 801101308 <br />Receipt #: <br />Date: <br />Permit: <br />26285 <br />03/02/2018 <br />M1977252 <br />Page 1 of 1 <br />Check #00957259 <br />4300-MTRO <br />Minerals Technical Revision <br />$216.00 <br />User: MSR <br />Payer: General Shale <br />TR05 <br />Receipt Total: <br />$216.00 <br />Page 1 of 1 <br />