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UNITED STATES POSTAL SERVICE <br />EerN <br />Mail <br />Fees Paid <br />G-10 <br />• Sender: Please print your name, address, and ZIP+4® in this box* <br />RECEII./`C <br />State of Colorado <br />Department of Natural Resources NOV 172015 <br />Division of Reclamation, Mining & Safety. <br />1313 Sherman Street, Suite 215 Division of Reclamatior,, <br />Denver, CO 80203 Minin'V & Safety <br />C-1981014 <br />SI -3 <br />Notifications of Bond <br />Release Inspection <br />i1}lf1f1111i1���ttlr��#lr#���alt,j,:,B,l� I <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 <br />❑ Agent <br />El Addressee <br />Received by (Printed Nam C. Date f D livery <br />INfa A - �wv1 CV <br />tf in <br />D. Is delivery address different from item 1? ❑ Gs <br />If YES, enter delivery address below: ❑ No <br />Ted Coulter <br />210 Lovers Lane <br />Grey arvice Type <br />--80231Certified <br />Mail® 13 Priority Mail Express' <br />— I Registered ❑ Return Receipt for Merchandise <br />LI Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(Transfer from service label) 7 014 0150 0000 913 8 6676 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />