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UNITED STATESi, PS-WMt VICE <br />First -Class Mail <br />a- Postage & Fees Paid <br />USPS <br />='-w Permit No. G-10 <br />c N. <br />• Sender: Please print your name, address, and �..ZlP+4® in is box• <br />6 M �4 , F D <br />State of Colorado 2015 <br />Department of Natural Resources SEP L r <br />Division of Reclamation, Mining & S$fon of Reclamation, <br />1313 Sherman Street, Suite 215 <br />Denver, CO 80203 __ __ - - Mining & Safety <br />C198j_008 <br />S07..�:nn Notification <br />tji,tl,i�fisl <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 />MRALAN BOEHMS <br />OFFICE OF SURFACE MINING <br />WESTERN REGIONAL COORDINATING <br />CENTER <br />1999 BROADWAY, SUITE 3320 <br />DENVER, CO 80202 <br />A. Signat <br />X ❑Agent <br />❑ Addressee <br />B. eceived 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® ❑ Priority Mail Express'"' <br />❑ 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 9578 <br />(Transfer from service label) <br />PS Form 3811, July 2013 Domestic Return Receipt <br />