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UNITED STATESTSFRVICE <br />17 ;FEB F1r; <br />PIA 8 i1 <br />First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G-10 <br />• Sender: Please print your name, addre <br />i s box- <br />State of Colorado FEB L < LU l° <br />Department of Natural Resources N OF RECLAMATION <br />Division of Reclamation, Mining & MKING AND SAFETY <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 <br />SpecClUlotq <br />D. Is delivery address different from item 1? <br />File Roz. <br />C-1981-014 <br />No <br />SL -4 Letter <br />Inspection Notification <br />RDZ <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 />William Metz <br />122 Hannah Marie PI. <br />Toney, AL 35773-9645 <br />A. Si tur <br />FY <br />X <br />B. Received by (Printe e) <br />� <br />tr-ixlvz� <br />D. Is delivery address different from item 1? <br />'13 WS <br />If YES, enter delivery address below: <br />No <br />3. Service Type <br />9KCertified 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 7 014 212 0 0001 7 8 6 9 7247 <br />(transfer from service lai: <br />PS Form 3811, July 2013 Domestic Return Receipt <br />