Laserfiche WebLink
UNITED STATES POSTALISIVF� <br />• Sender: Please print your name, address, <br />wn - ; 1t�16 <br />State of Colorado " <br />Department of Natural Resources DyWoN OF RECLWATIC + <br />Divisi of Reclamation, Mining & Safety jMNiNGAND S4ETY <br />1313 Iffi% 215 <br />Denver, CO 80203 <br />RE AUG 1 7.�(Jl�i C-1981-008 <br />SL -19 <br />OV OF,! I """s'-' Inspection Notification <br />IGi ai ggyy f■ : 1:.,..e <br />!�' f�C�.ifl:!'l�fi7l��1"�f�lll'llti�lf �f P'<ff0•}��i•'�Gt 7'i fel 11 fi <br />lrttN I r, f fff <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 />A. Signature <br />X <br />13 Agent <br />❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />TMR47 LLC <br />7465 S 1500 E <br />3. Service Type <br />Price, UT 84501-7802 ❑ Certified Mail® ❑ Priority Mail Express' <br />❑ R ' t d ❑ Return Recei t for Merchandise <br />2. Article Number <br />(Transfer from service label) <br />egis ere p <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />7014 2120 0001 7871 0250 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />