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UNITED STATES;P6STAL SERVICE 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 '�G_1 <br /> File /14-IG-67- <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature., <br /> item 4 if Restricted Delivery is desired. " - .J� ❑Agent <br /> ■ Print your name and address on the reverse "x '" ' / C' _!_EjAddwssee <br /> so that we can return the card to you. B. Received by`Printed Name) C. Date of Delivery <br /> ■ Atta-�h this card to the back of the mailpiece, ��` L <br /> or c i the front if space permits. . a L. <br /> — -- D. Is delivery address different from item 1? ❑Yes <br /> 1. Artice v,ddressed to: If YES;enter delivery address below: ❑No <br /> i <br /> 1 <br /> o Gary Pollack <br /> 11415 Palomar St. 3. service Type <br /> Spring Hill, FL 34609 ❑Certified Mail® ❑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 /> (Transfer from service label) 7 014 2120 0001 7885 3568 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />