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UNITED STATES �T �SIYRVICE First-Class Mail <br /> �r� Postage&Fees Paid <br /> 17 �,-EB '16 USPS <br /> Permit No.G-10 <br /> • Sender: Please print your name, addre i s box* <br /> State of Colorado FEB L L LU 16 <br /> Department of Natural Resources N OF RECLAMATION <br /> Division of Reclamation, Mining&ftING AND SAFETY <br /> 1313 Sherman Street, Room 215 <br /> Denver,CO 80203 Spec jU oLq <br /> File RUz, <br /> C-1981-014 <br /> SL-4 <br /> Inspection Notification Letter <br /> RDZ #,lIII bllCOMPLETE THIS �iiPtf, <br /> SECTIONSENDER: COMPLETE THIS SECTION <br /> . <br /> ■ Complete items 1,2,and 3.Also complete A. si <br /> item 4 if Restricted Delivery is desired. <br /> ■ Print your name and address on the reverse X �/� � Agent <br /> so that we can return the card to you. ❑Addressee <br /> t1-1 A <br /> ■ Attach this card to the back of the mailpiece, B• eived by(Priv Name) C. Date f Delivery <br /> , <br /> or on the front if space permits. � ,-;N I <br /> 1. Article Addressed to: D. Is delivery a ss different from item 1? 0 es <br /> Y If YES,enter delivery address below: 1:1No <br /> City of Florence <br /> 600 West 3rd Street <br /> Florence, CO 81226-1117 <br /> 3. Service Type <br /> I I I I I I I l I l l 1R Certified Mail® ❑Priority Mail Express'"' <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) I]Yes <br /> 2. Article Number <br /> (Transfer from service labe 7014 212 0 0001 7869 7155 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />