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2014-11-03_REVISION - C1981038 (4)
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2014-11-03_REVISION - C1981038 (4)
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Entry Properties
Last modified
8/24/2016 5:55:12 PM
Creation date
11/3/2014 12:37:19 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981038
IBM Index Class Name
Revision
Doc Date
11/3/2014
Doc Name
Certified Return Receipt (Inspection Notification)
From
OSM
To
DRMS
Type & Sequence
SL5
Email Name
MLT
DIH
Media Type
D
Archive
No
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SL!-j <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 />Alan Boehms <br />Office of Surface Mining <br />Western Regional Coordinating Center <br />1999 Broadway, Suite 3320 <br />Denver, CO 80202 <br />A. Signatur <br />Co <br />r,l <br />.. Only; <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />ru <br />m <br />Postage: <br />$0.48 <br />-``x$3.30 <br />Certified Fee: <br />C3 <br />Return Receipt Fee: <br />-,r $2.70 <br />C3 <br />Rsern <br />.ti � <br />0 <br />O <br />(Endorsem Total Postage & Fees: '•_ <br />6.48 <br />�� <br />rW� <br />Restnctec� <br />C3 <br />(Endorsement required) <br />r �0\ <br />Total Postage & Fees $ <br />oz <br />ru <br />Sent To <br />Alan Boehms <br />Ok &Sa <br />p <br />r- <br />street, AF Office of Surface Mining <br />or PO 6o, western Regional Coordinating <br />-__ -------------- <br />Center <br />Q�� _^��o�g <br />i�" <br />Ctry State 1999 Broadway, Suite 3320 <br />Denver, CO 80202 <br />PS Form 1—mull, rr. <br />See Reverse for Inst <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 <br />Western Regional Coordinating Center <br />1999 Broadway, Suite 3320 <br />Denver, CO 80202 <br />A. Signatur <br />❑ Agent <br />❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />o. oervice type <br />❑ Certified Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) 13 Yes <br />2. Article Number 701,2 346D QOQO 6384 6228 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt <br />_ 102595 -02 -M -1540 <br />
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