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i <br />UNITL� �'F'�-�0�`TA��EF�/I`LEt• � :� E'„ �-5 '� `' '`. <br />• Sender: Please print your name, address, <br />OCT 0 -4 2016 <br />State of Colorado <br />Department of Natural Resources DMSfON OF RECLAMATION <br />Division of Reclamation, Mining & Safi M�NIN� A��D SAFETY <br />1313 Sherman Street, Room 215 C-1981-041 <br />Denver, CO 80203 SL -9 <br />Inspection <br />Notification <br />jle/dih <br />hi' ill 1iIdiI111ilillili,jijjl�ii'tlil�lilli�ijiiilii=ji,ll'"111 <br />■ Complete items 1, 2, and I Also complete 71RIeceived <br />item 4 if Restricted Delivery is desired. <br />■ Print your name and address on the reverse 13 Agent <br />so that we can return the card to you. D Addre <br />■ Attach this card to the back of the mailpiece, Printed Name) WaY <br />of Deli <br />or on the front if space permits. � (� <br />1. Article Addressed to: <br />Rudy and Ethel I <br />Fontanari <br />3316 E 3/4 Road <br />Clifton, CO 81520 <br />D. Is delivery address different from item 1. ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />,3. oervlce type <br />❑ Certified Mail® ❑ Priority Mail Express - <br />0 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) <br />2. Article Number <br />(Transfer from service label) ?014 212 0 <br />01101 7871 p 5 4 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />❑ Yes <br />