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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977219 <br />Receipt #: <br />Date: <br />5197 <br />Summit Brick & Tile Co. <br />Permit: <br />000000000 <br />78259 14300-01 1 Minerals Annual Fees <br />M-1977-219, Paid By Summit Brick Company <br />03/23/2009 <br />M1977219 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1