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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1979221 <br />01 <br />General Shale Brick, Inc. <br />Receipt #: <br />Date: <br />Permit: <br />000000000 <br />638136 14300-01 <br />Minerals Annual Fees <br />M-1979-221 <br />Receipt Total: <br />8743 <br />08/04/2010 <br />M1979221 <br />$791.00 <br />$791.00 <br />Page 1 of 1