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• 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 />Article Addressed to: <br />Moffat County Commissioners' <br />County Commissioner <br />221 W Victory Way <br />Craig, CO 81625 <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />A. Signature <br />X ❑ Agent <br />U ❑ Addressee <br />B. Received by (Printed Name) C. Da a of Delivery <br />D. Is delivery address different from item 1? Y <br />If YES, enter delivery address below: ❑ No, <br />3. Service Type <br />ertified Mall ❑ Express Mall <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />7012 3460 0000 6384 6280 <br />Domestic Return Receipt <br />.......... ». <br />UNITEl e" s r -1 C- C'- e.: Firrsr las <br />} z•, c: ;,r "rF "`ft� "� �FBerMfif'Tda� <br />Sender: Please print your name, address, and Zlfbgin this box • <br />State of Colorado <br />Department of Natural Resources SEP <br />Division of Reclamation, Mining & Safl ;,�jnn of e32014 <br />1313 Sherman Street, Suite 215 '11'n RPznl <br />Denver, CO 80203 Spec* ' �W <br />File <br />SL_-1 <br />. 1111, Ili, ii1l llll if l- 1i- 11, iilitl li'llllill'li�i�i�liiillili1111 <br />