Laserfiche WebLink
UNITED STATes, P05T,gL SERVICE <br />co _Z0012 First -Class Mail <br />_•�' J 5;y r Postage & Fees Paid <br />USPS <br />Permit No. G-10 <br />• Sender: Please r' t <br />6'10brinl fete 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 />P In your name, address, and ZIP+4® in this box• <br />STATE OF COLORADO <br />DEPARTMENT OF NATURAL <br />DIVISION OF RECLAMATIONRESOURCES <br />1313 SHERMAN STREET, SUI, MININ <br />TE 215G &SAFETY <br />DENVER, CO 80203-224.3 <br />r <br />C1981-019 <br />SL -8 <br />Inspection Notif <br />�itlilrr,l!"�'!t!!lt:lil�llifii i }� jWahh <br />A. Signature <br />X /� � ❑Agent <br />a ❑ 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 />Christine Belka <br />Office of Surface Mining <br />1999 Broadway Ste 3320 3. Service Type <br />Denver, CO 80202-3050 ❑ Certified Mail® O Priority Mail Express- <br />_ ❑ Registered O Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7012 3460 0000 6384 7836 <br />(Transfer from service iabeo <br />PS Form 3811, July 2013 Domestic Return Receipt <br />