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UNIT } TeAA RV ?t <br />1 1-114A � :_11(115 pfd s' <br />• Sender: Please print your name, address, and ZIP +4® in this box* <br />RECEIV w <br />State of Colorado MAR 2 -r 2015 <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safe %jision of Rena 06 ON 1313 Sherman Street, Suite 215 in-in <br />Denver, CO 80203 C -19 <br />CV - 2014 -008 <br />Notice <br />& Order to Pay <br />FlXed Penalty <br />• Complete items 1, 2, and 3. Also complete A. <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse X <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, B' <br />or on the front if space permits. <br />1. Article Addressed to: <br />Oxbow Mining, LLC <br />P.O. Box 535 <br />3737 Highway 133 <br />Somerset, CO 81434 <br />❑ Agent <br />O Addressee <br />amej� C. Date of Delivery <br />D. Is delivery address different from item 1? O Yes <br />If YES, enter delivery address below: O No <br />�. oerwce type <br />O Certified Mail® ❑ Priority Mail EXpreSSTM <br />O Registered O Return Receipt for Merchandise <br />❑ Insured Mail O Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) <br />2. Article Number ❑Yes <br />Mransfer from service la 7012 3460 0000 6384 6099 <br />PS Form 3$1 1, July 2013 Domestic Return Receipt <br />