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2014-10-10_REVISION - C1981010 (2)
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2014-10-10_REVISION - C1981010 (2)
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Entry Properties
Last modified
8/24/2016 5:48:48 PM
Creation date
10/15/2014 7:49:55 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981010
IBM Index Class Name
Revision
Doc Date
10/10/2014
Doc Name
Certified Return Receipt (Inspection Notification Letter)
From
OSM
To
DRMS
Type & Sequence
SL16
Email Name
JLE
DIH
Media Type
D
Archive
No
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UNITED STATES T RVICE <br />,-1 <br />First -Class Mail j <br />Postage & Fees Paid <br />USPS i <br />Permit No. GA i <br />i <br />• <br />Sender: Please print your name, address, and ZIP +4 in tX' <br />"I;. <br />State of Colorado <br />Department of Natural Resources <br />Division of Reclamation, Mining &Safety <S)\ <br />1313 Sherman Street, Suite 215 `r &� <br />Denver, CO 80203 <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 />Alan Boehms <br />Office of Surface Mining Center <br />Western Regional to Coordinating <br />1999 Broadway, <br />Denver, CO 80202 <br />JLE /DIH <br />C- 1981 -010 <br />SL -16 Insp Notification Letter <br />iil1, }liiiilllif�illi }iiililtflll }If ijll; =i' +�[T'll'�T "- �;i•��, <br />A. <br />0 Agent <br />B. R eived by ( Printed Name) I C. Date of Delivery <br />D. Is delivery address different from "em 1? 0 e <br />If YES, enter delivery address below: 0 No <br />3. service Type <br />0 Certified Mail 0 Express Mail <br />0 Registered 0 Retum Recelpt for Merchandise <br />0 Insured Mail 0 C.O.D. <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number 701,0 1060 0001 0936 6002 <br />(transfer from service label) 102595 -02 -M -1540 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />i <br />i <br />i <br />i <br />i I <br />I <br />
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