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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1977251 <br />r General Shale Brick <br />Receipt #: <br />Date: <br />Permit: <br />7673 <br />03/03/2010 <br />M1977251 <br />000000000 <br />614656 4300-01 Minerals Annual Fees <br />M-1977-251 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1