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SENDER: COMPLETE. THIS SECTION <br />• Complete items 1, 2, and 3. <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 />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 <br />IIIIII <br />111 <br />11 <br />111111111111 <br />111 <br />1111111111 <br />9590 9403 0111 5077 4305 47 <br />2. Article Number (Transfer from service label) <br />7015 0640 0007 7571 82 <br />COMPLETE THIS SECTION ON DELIVERY <br />A. Signature <br />X <br />❑ Agent <br />❑ Addressc <br />B. Received by�(P kited Name) C. Date of Delivei <br />291 <br />D. Is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />❑ Adult Signature <br />❑ Adult Signature Restricted Delivery <br />Certified Mail® <br />❑ Certified Mail Restricted Delivery <br />0 Collect on Delivery <br />0 Collect on Delivery Restricted Delivery <br />ail <br />88 ail Restricted Delivery <br />0 Prionty Mail Express® <br />❑ Registered MaIITM <br />❑ Registered Mail Restric <br />Delivery <br />❑ Return Receipt for <br />Merchandise <br />❑ Signature Confirmation <br />❑ Signature Confirmation <br />Restricted Delivery <br />PS Form 3811, April 2015 PSN 7530-02-000-9053 <br />UNITED STATES POSTAL SERVICE <br />Domestic Return Receip <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 />1 <br />9 <br />Connie N. Davis <br />Aggregate Industries <br />P. O. Box 337231 <br />Greeley, CO 80633 <br />NIXIE SOS CE 1 <br />N <br />80 <br />3C: <br />RI a 1 is T v <br />DELI VERA) L E <br />'NA3L5 TO <br />03224365 <br />B603/05/16 <br />L Ib V f\ <br />AS ADDRESSED <br />F OR WARD <br />'19613-03930-04-07 <br />