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■ Complete items 1, 2, and 3. Also complete A. Signature <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. B. Received by (Printed Nam <br />■ Attach this card to the back of the mailpiece, <br />or on the front if space permits. C l/ <br />1. Article Addressed to: <br />Mr Allen Boehms <br />Denver Field Division <br />Office of Surface Mining Administration an, <br />1999 Broadway, Suite 3320 <br />Denver, CO 80202-5733 <br />I�illll�il�l�iilllni�li��li'Illl�llllill��ll <br />❑ Agent <br />❑ Addressee <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: / <br />3. Service Type <br />b Certified Mail® ❑ Priority Mail Express - <br />0 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />• <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(Transfer from service label)7 014 2120 0001 7869 7285 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />RECN E® <br />sr ra ri. <br />FEB'� ', �Q 16 UNITED STATES f�OkTA&§j;1RVICE EPermitNoG <br />t-Class Mail <br />CC 4� tage & Fees Paid <br />PS <br />( iON OF RECLAMATION 10 FEL9, '145 -10 <br />WING AND SAFETY PA I <br />• Sender: Please print your name, address, and ZIP+4® in this boxes <br />State of Colorado <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 Spec <br />File f kT <br />tll�r!!IlI1111�111u1lIII�l11Ilullnl'I►�thJtt»tJtl�tytt,Jt, <br />