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Acme Brick Company <br />000000000 <br />Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1989052 <br />Receipt #: 14028 <br />Date: 10/31/2012 <br />Permit: M1989052 <br />Payment Method Revenue Code Fee DescnptiornlNotes Amount <br />1219811 <br />4300 -01 <br />Minerals Annual Fees <br />M- 1989 -052, CMB <br />$323.00 <br />Receipt Total: I $323.00 <br />Page 1 of 1 <br />