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2013-12-17_REVISION - C1994082
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2013-12-17_REVISION - C1994082
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Entry Properties
Last modified
8/24/2016 5:38:10 PM
Creation date
12/19/2013 8:53:13 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1994082
IBM Index Class Name
Revision
Doc Date
12/17/2013
Doc Name
Certified Return Receipt (Inspection Notification Letter)
From
Dennis A & Laurie L. Hallenbeck
To
DRMS
Type & Sequence
SL5
Email Name
JHB
DIH
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 I Ii <br />State of Colorado <br />Department of Natural Resources QEG <br />Division of Reclamation, Mining & Safety GF REG�IA�, <br />SPA <br />���w <br />1313 Sherman Street, Suite 215 pMs, AND <br />Denver, CO 80203 <br />C- 1994 -082 ion Letter <br />SL-5 Notificat <br />nspection <br />i <br />I, <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 />Denni,A. and Laurie L. Hallenbeck <br />36190- -County Road 27 <br />Hayden, CO 81639 <br />A S' at a x% _i <br />// ®Agent <br />� ❑Addressee <br />B. Received by (Printed, am�e c. Date pf Delivery <br />D. Is delivery address Brent m item 1? ❑ Yes <br />If YES, enter delivery address below: Ea-No <br />3. Service Type <br />❑ Certified Mail ❑ Express Mail <br />❑ Registered ❑ Retum Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restrictarl nmii. <br />- - - -•-. a Y.. <br />(rransfer from service label) 7 010 10 6 D D D O 1 0936 9 2 7 0 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102595 -02 -M -1540 <br />
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