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Division of Reclamation, Mining, and Safety <br /> Fee Receipt for M1979045 <br /> The Lakewood Brick and Tile Company Receipt#: 47956 <br /> Thomas Murray Date: 07/29/2024 <br /> 1325 Jay St Permit: M1979045 <br /> Lakewood CO 802142052 <br /> Payment Method Revenue Code Fee Description/Notes Amount <br /> Check#172904 4300-MTRO Minerals Technical Revision $216.00 <br /> User: RY1 <br /> Payer: Summit Brick Company <br /> TR-5 <br /> • Receipt Total: $216.00 <br /> Page 1 of 1 <br />