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2015-01-21_REVISION - C1981028
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2015-01-21_REVISION - C1981028
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Entry Properties
Last modified
8/24/2016 5:56:46 PM
Creation date
1/29/2015 1:07:52 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981028
IBM Index Class Name
Revision
Doc Date
1/21/2015
Doc Name
Certified Return Receipt (Inspection Notification)
From
OSM
To
DRMS
Type & Sequence
SL7
Email Name
JLE
DIH
Media Type
D
Archive
No
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CI V OV ER �/ <br />UNITED STATES S�VICE ' Y First -Class Mail <br />Postage & Fees Paid <br />12015 uSPS <br />` f Permit No. G -10 <br />• Sender: Pie ase print your name, Midis %Qn Is box • <br />MINING AND SAF <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 <br />C- 1981 -028 <br />SL-7 <br />Inspection Notification <br />ii jle /ahh <br />lif pill illi�t�,�i„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 />, 11- - III II I i-i-III1'1Tr"TI "I <br />Alan Boehms <br />Office of Surface Mining <br />Western Regional Coordinating Center <br />1999 Broadway, Suite 3320 <br />Denver, CO 80202 <br />A. Signature <br />X gent <br />❑ Addressee <br />B. heceived 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 />3. Service Type <br />❑ Certified Mail E3 Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ yes <br />2. Article Number <br />(Transfer from service label) 7 010 3460 0 0 0 0 6384 617 4 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />
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