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Division of Reclamation, Mining, and Safety <br />Fee Receipt for M1978011 <br />General Shale Brick, Inc. <br />000000000 <br />834114 jwd 4300 -01 1 Minerals Annual Fees <br />M- 1978 -011 <br />Receipt #: <br />Date: <br />Permit: <br />15778 <br />08/13/2013 <br />M1978011 <br />$791.00 <br />Receipt Total: 1 $791.00 <br />Page 1 of 1 <br />