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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978014 <br />General Shale Brick, Inc. <br />Receipt #: <br />Date: <br />Permit: <br />8741 <br />08/04/2010 <br />M 1978014 <br />000000000 <br />638134 14300-01 1 Minerals Annual Fees <br />M-1978-014 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1