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UNITED STATES POSTAL INW&PINIED <br />• Sender: <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 />Staats, Melvin and <br />Lea,Ann <br />P.O Box 10 <br />Nucla, CO 81424 <br />AUG 16 2016 <br />First -Class Mail <br />Postage & Fees Paid <br />USPS <br />=Perrt�it�l -10 <br />address, and ZIP+4® in this bok* <br />State of Colorado <br />Department of Natural Resources t. ", <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Suite 2 <br />Denver, CO 80203 C-1981-008 <br />SL -19 <br />Inspection Notification <br />bf}}b/a h h <br />ttt!IlIi=h�Istiiltiliid3�i1�11}t�"I{,,�i{lilif{lli�lilllll�I'; <br />A. Signature <br />-I hr\ ❑ Agent <br />❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />< <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />❑ Certified Mails ❑ Priority Mail Express- <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />( 7 014 2120 0001 7871 0625 <br />Transfer from service label) <br />PS Form 3811, July 2013 Domestic Return Receipt <br />