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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1991003 <br />Receipt #: <br />Date: <br />10259 <br />General Shale Brick, Inc. <br />Permit: <br />000000000 <br />723115 1 4300-01 1 Minerals Annual Fees <br />M-1990-003 <br />04/06/2011 <br />M1991003 <br />$791.00 <br />Receipt Total: $791.00 <br />Page 1 of 1 <br />