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COMPLETE •N COMPLETE THIS SECTIONON DELIVERY
<br /> ■ Complete items 1,2,and 3.Also complete A. SignatUre tessE
<br /> item 4 if Restricted Delivery is desired,■ Print your name and address on the reverse X ❑
<br /> so that we can return the card to you. BVReceived by(Printed Na r
<br /> ate of flelive
<br /> ■ Attach this card to the back of the mailpiece, o
<br /> or on the front if space permits.
<br /> 1. Article Addressed to: D. Is delivery address different m 1? ❑Yes
<br /> If YES,enter delivery address el(SR n I r ❑ No
<br /> Lee Roy and Marlene J Rothe
<br /> 19727 Factory St 3. S rvice Type
<br /> Sterling, CO 80751 WCertifiedMail® ❑Priority Mail Express—
<br /> ❑Registered ❑Return Receipt for Merchandi:
<br /> _ - - ❑ Insured Mail ❑Collect on Delivery
<br /> 4, Restricted Delivery?(Extra Fee) ❑Yes
<br /> 2. Article Number(transfer from service labe 7 014 2120 0001 8040 0 613
<br /> l)
<br /> PS Form 3811,July 2013 Domestic Return Receipt
<br /> Certified Mail service provides the following benefits: U.S. Postal ServicC
<br /> is A Certified Mail receipt(this portion of the L>I mailpiece;include applicable postage to
<br /> Certified Mad label. cover the return receipt service fee;and CERTIFIED MAIL@
<br /> RECEIPT
<br /> is A unique identdie8pwc mallplece. f� endorse the mailpiece"Return Receipt
<br /> ■Electronic verification of delivery or attempted Requested,"or see a retail associate for rE 1Domestic
<br /> delivery. µ I (,��©� sistance.For an electronic return receipt, ra
<br /> ■A record of deliveiyl�aIaeirLgilgCip1 'S e a retail associate for assistance.To pFor delivery
<br /> nature)that is retained by the Postal —Weive AAuplicaM return receipt,present p information, I
<br /> signature) this USPS'-postmarked Certified Mail rr t' `'
<br /> Service for a specified period. receipt to the retail associate,who will p
<br /> Important Reminders: provide a duplicate return receipt for no =11- �J
<br /> ■You may purchase Certified Mail service with additional fee. C3 Postage $ p U
<br /> First-Class Mail',First-Class Package -Restricted delivery service,which provides cc
<br /> Service',or Priority Mail'service. delivery to the addressee specified by name, Certified Fee 3.
<br /> in Certified Mail service is not available for or to the addressee's authorized agent. r_Zl Rek
<br /> international mail. Include applicable postage to cover the C3 ReturnReceipt Fee
<br /> inInsurance coverage is not available for restricted delivery fee and endorse the C3 (Endorsement Required) L
<br /> purchase with Certified Mail service.However, mailpiece"Restricted Delivery,"or see a GLLQ
<br /> the purchase of Certified Mail service does not retail associate for assistance. E:3 Restricted Delivery Fee
<br /> change the insurance coverage automatically ■To ensure that your Certified Mail receipt is (Endorsement Required)
<br /> included with certain Priority Mail items. accepted as legal proof of mailing,it should ru �?
<br /> is For an additional fee,you may request the bear a USPS postmark.If you would like a ra Total Postage&Fees $ i/r 15 i7 SG=j
<br /> following services: postmark on this Certified Mail receipt,please ru —
<br /> -Return receipt service,which provides you present your Certified Mail item at a Post Sent To
<br /> with a record of delivery(including the Office'"for postmarking If you don't need a
<br /> recipient's signature)You can request a postmark on this Certified Mail receipt,detach
<br /> hardcopy return receipt or an electronic the barcoded portion of this label,affix it to the C3 Street&AE Lee Roy and Marlene J Rothe
<br /> version.For a hardcopy return receipt, �mapilpiece,apply appropriate postage,and or PO Box
<br /> c��ROMAN sue''"V Rof�'8l2ii sra1`e't{r r CfnQfor80203 records.
<br /> r` City Siite, 19727 Factory St
<br /> PS Form 3800,July 2014(Reverse)PSN 7530-02-000-9047 IMP M. Sterling, CO 80751
<br /> UNITED STATES-POST '.,ERVICE
<br /> First-Class Mail
<br /> Postage&Fees Paid
<br /> USPS
<br /> ' = Permit No.G-10
<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 Spec emP
<br /> File 121 W 5 G 1-7
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