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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977317 <br />Summit Brick and Tile Co. <br />Receipt #: <br />Date: <br />Permit: <br />4523 <br />12/17/2008 <br />M1977317 <br />000000000 <br />75915 1 4300-01 1 Minerals Annual Fees <br />M-1977-317, Paid by Summit Brick Company <br />$323.00 <br />Receipt Total: $323.00 <br />Page 1 of 1