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2013-11-12_REVISION - C1981010
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2013-11-12_REVISION - C1981010
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Entry Properties
Last modified
8/24/2016 5:37:13 PM
Creation date
11/14/2013 9:01:58 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
REVISION
Doc Date
11/12/2013
Doc Name
Certified Return Receipt (Inspection Notification)
From
Colorado State Land Board
To
DRMS
Type & Sequence
SL15
Email Name
JLE
SB1
Media Type
D
Archive
No
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�� �22p13 <br />UNITED STATES POSTAL SERVICE <br />First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />• Sender: Please print your name, address, and ZIP +4 in this box • <br />State of Colorado <br />Department of Natural Resources <br />Division of Reclamation. Mining & Safety <br />1313 Sherman Street, Suite 215 <br />Denver, CO 80203 JLE, SB1 <br />C- 1981 -010 <br />SL -15 Insp Notification Lt <br />H "Illi" 1,11"lillhil till,1 1111111Wd,1111iii11111ii11111 <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 />Jerod Smith <br />Colorado State Land Board <br />P O Box 1094 <br />Craig, CO 81626 <br />2. Article Number <br />(Transfer from service label) <br />I PS Form 3811, February 2004 <br />A. Signature <br />X „ Agent <br />' 4Addressee <br />B. Received by (Printed Nam I C. Date of Delivery <br />V <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: l9 No <br />3. Se ce Type <br />Certified mail ❑ Express Mail <br />❑ Registered O Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />7011 3500 0002 9605 5082 <br />Domestic Return Receipt 102595 -02 -M -1540 <br />
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