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2016-05-09_REVISION - C1980007 (2)
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2016-05-09_REVISION - C1980007 (2)
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Entry Properties
Last modified
8/24/2016 6:21:50 PM
Creation date
5/11/2016 1:02:25 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980007
IBM Index Class Name
Revision
Doc Date
5/9/2016
Doc Name
Certified Return Receipt (Inspection Notification)
From
US BLM
To
DRMS
Type & Sequence
SL9
Email Name
LDS
JRS
Media Type
D
Archive
No
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UNITED STATES POSTAL SERVICE <br />Class Mail <br />& Fees Paid <br />Eg4t�"'. G-10 <br />• Sender: Please print your name, address, and Zti�+4® in <br />■ 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 />■ Attach this card to the back of the mailpiecE <br />or on the front if space permits. <br />1. Article Addressed to: ; <br />Dave Lazorchak <br />U.S. Bureau of Land Management <br />Gunnison Field Office <br />210 W. Spencer Ave <br />Suite A <br />Gunnison, CO 81230 <br />State of Colorado <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safe <br />1313 Sherman Street, Suite 215 <br />>��0203 .007 �P : oe tter <br />`L <br />a 7016 G 19 action N°trEfi��atrf <br />InsP <br />�.1�atu�(ON Idslahh <br />A. Signature ❑Agent <br />❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />s delivery address different from item 1? No <br />if YES, enter delivery address below: El <br />1 <br />.j <br />3. Service Type <br />❑ Certified Mail® ❑ Priority Mail Express'" <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail 0 Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7 014 2120 0001 7871 0 410 <br />(Transfer from service label) <br />PS Form 3811, July 2013 <br />Domestic Return Receipt <br />
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