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UNITED STATES POSTAL SERVICE First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G-10 <br />• Sender: Please print your name, address, and ZIP+4® in this box" <br />RECL7-.ivr=n <br />State of Colorado <br />Department of Natural Resources SEP 2 3 2015 <br />Division of Reclamation, Mining & Safety DIVISION OF <br />1313 Sherman Street, Suite 215 =GL TION, <br />Denver, CO 80203 MINING AND SAFETY <br />C1981-008 <br />SL -17 <br />Inspection Notification <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 />A. <br />X <br />3 gent <br />B. Received by(Printed Name) C: Date of Delivery <br />D. Is d very address different from item 1? ❑ Yes <br />If YES, enter delivery address below: 1WNo <br />Elma E. Burbridge <br />Burbridge, Ward E and Elma E <br />P.O. Box 92 C� Service Type <br />N ucla, CO 81414-0092 Certified Mail® 13 Priority Mail Express'" <br />7 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7 014 0150 0000 913 8 9585 <br />(transfer from service /abet) <br />PS Form 3811, July 2013 Domestic Return Receipt <br />