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2013-11-06_REVISION - C1981010
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2013-11-06_REVISION - C1981010
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Entry Properties
Last modified
8/24/2016 5:37:06 PM
Creation date
11/6/2013 1:00:06 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
REVISION
Doc Date
11/6/2013
Doc Name
Certified Return Receipt (Inspection Notification Letter)
From
OSM
To
DRMS
Type & Sequence
SL15
Email Name
JLE
SB1
Media Type
D
Archive
No
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UNITED STATES POSTAL SERVICE First -Class Mail <br />Postage & Fees Paid <br />LISPS <br />Permit No. G -10 <br />• Sender: Please print your name, address, and ZIP +4 in this box • <br />State of Colorado�(d <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Suite 215 _ <br />Denver, CO 80203sloN C : sF <br />JLE, SB1 W y <br />C- 1981 -010 <br />SL -15 Insp. Notification Lt <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Jeffrey W Fleischman <br />Office of Surface Mining <br />Western Regional Coordinating Center <br />1999 Broadway, Suite 3320 <br />Denver, CO 80202 <br />A. Signature <br />❑ Agent <br />X U` G^7� ❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />L✓ d, hZ_l� .�77- l t / f /2 <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />/�No <br />3. Service Type <br />❑ Certified Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7010 1060 0001 0936 4992 <br />(transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />
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