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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978009 <br />General Shale Brick <br />000000000 <br />588290 I 4300-01 I Minerals Annual Fees <br />M-1978-009 <br />Receipt #: <br />Date: <br />Permit: <br />6304 <br />08/06/2009 <br />M1978009 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1