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:S END E R,. COMPL ETE THIS.: SECTION <br />N 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 />I� Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Mr. Randy Geist <br />Loloff Construction, Inc. <br />801 8th Street, Suite 130 <br />Greeley, CO 80631 <br />COMPLETE THIS SECTION ON DELIVERY <br />A. Si.natylre <br />cif Agent <br />0 Address <br />B _Received Jpy (Prfnte N e) C. j;ate� Dejive <br />77( <br />D. Is delivery ddress different frim item 1? ❑ Yes <br />If YES, enter delivery address below: 0 No <br />3. Service Type <br />❑ Certified Maile 0 Priority Mail Express'' <br />❑ Registered 0 Return Receipt for Merchandi: <br />0 Insured Mail 0 Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number <br />(Transfer from service label) <br />7014 0150 0000 9138 9189 <br />PS Form 3811, July 2013 <br />UNITED STATESAP6StACSLRVICE <br />Domestic Return Receipt ' <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 />STATE OF COLORADO <br />DEPARTMENT OF NATURAL RESOURCES <br />DIVISION OF RECLAMATION, MINING & SAFETY <br />1313 SHERMAN STREET, SUITE 215 <br />DENVER, CO 80203 <br />Spec. Pill <br />File MI <br />IIIIiiII.IsIIntIiJIIItMilli,t,iiiilitititll"iltiiiili„ii,itil <br />32243E <br />