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UNITED STATES POSTAI SERVICE <br />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 />RECEIVEm <br />Lj <br />State of Colorado <br />Department of Natural Resources NOV 17 2015 <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Suite 215 Division o� Reclamation, <br />Denver, CO 80203 Minim & Safety <br />C-1981014 <br />SI -3 <br />Notifications of Bond <br />Release Inspection <br />111111) lilt ���fl �$�II►f f� ttf , ii ►=i@, i� iYa1� ii <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. Signat re j /I <br />X �- ❑ Agent <br />❑ Addressee <br />S. 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 />Alan Boehms <br />Office of Surface Mining <br />Western Regional Coordinating Center <br />1999 Broadway, Suite 3320 rvice Type <br />Denver, CO 80202 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 <br />( 7 014 0150 0001 9138 6645 <br />Transfer from service label <br />PS Form 3811, July 2013 Domestic Return Receipt <br />