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iENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse X ❑Addressee <br /> so that we can return the card to you. B. Re eived y(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, •yl l G <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> James McCormick <br /> AcCorm Excavation & Paving, LLC <br /> 30887 Hw 24 <br /> Stratton, Cfl 80836 s. Service Type <br /> 16 Certified Mail® ❑Priority Mail Express' <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> ?. Article Number <br /> (Transfer from service labeq 7 014 2120 0001 7 8 6 9 6 516 <br /> 3S Form 3811,July 2013 Domestic Return Receipt <br /> IGNITED STATES-POrS`f"AL'�ERVICE First-Class Mail <br /> Postage&Fees Paid <br /> USPS <br /> T E'l x.i ; Permit No.G-10 <br /> VM <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 11 jQa Sp/ Spec �7Z/1- <br /> File ✓nda4 01 i) <br /> lilillilii...li 11 Jill I1111111111N1131Illilii,III Jill <br />