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2'129 QET6 0000 OS hTO L <br /> ■ Complete items 1,2,and 3.Also complete Vnatr' <br /> item 4 if Restricted Delivery is desired. J <br /> � ❑Agentw- <br /> ■ Print your name and address on the reverse ❑A `E <br /> so that we can return the card to you. Re ived by(Print d N me) C, aC�af�Selivery' <br /> ■ Attach this card to the back of the mailpiece, '�' ! � y PQ <br /> or on the front if space permits. l��C.r1 ' <br /> D. Is delivery address different from item ?, ❑Yes `, <br /> 1. Article Addressed to: If YES,enter delivery address below <br /> C.c,,lx JYltn�r�4�s , GLc <br /> SSb / �eSLto/'2 /err✓e <br /> L G 3. Se Type <br /> e 1La O <br /> 1 �a oQ(�3 S y y/ lH Certified Mail® ❑Priority Mail Express'" <br /> 7 ❑Registered RR"Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number ^� <br /> (Transfer from service label) 7Q f Q So �d q 3 S g� �`— <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES POST SERVICE First-Class Mail <br /> "t Postage&Fees Paid <br /> 2— }Zaf'^5R '_3 F 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, Room 215 <br /> Denver, CO 80203 Spec /ACV <br /> File -lqt Z'l2.1 <br />