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UNITED STATES POSTAL SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> USPS <br /> Permit No.G-10 <br /> U.S. Postal Service'" <br /> CERTIFIED MAILP RECEIPT <br /> ru Domestic Mail Only • Sender: Please print your name, address, and ZIP+45 in this box9 <br /> r- <br /> ru 7=, nmm <br /> Ln State of Colorado <br /> co <br /> ca Postage: 0 $0,465 Department of Natural Resources <br /> r_ <br /> $3300 <br /> r-91 "Certified Fee. 1201,F, $2.,700 Division of Reclamation, Mining&Safety <br /> C3 Return F 1313 Sherman Street, Suite 215 <br /> C3 (EnclorsemenReturn Receipt Se'LO- <br /> C3 Denver, CO 80203 M-1983-216 <br /> Restricted D <br /> Co (Enclorsemen ee�-- SJM GRM AJW <br /> Co Total Postage & F $6.465 30-day Grace letter <br /> r-4 Total Postage&Fees I$ <br /> nj <br /> 't To <br /> Stacey Mascarenas <br /> ------------ <br /> C3 Mesa County <br /> r%- or PO Box No. p.0.Box 20000-5025 ----------------- <br /> City Slate,ZIP+4 Grand Junction,CO 81502 <br /> PS Form 3800,July 2014 See Reverse for Instructions Certified Mail Sarvir-P nrnuirl--+h-4-'lowing benefits- <br /> B A Certified Mail recei M-1983-216 letter a;include applicable postage to <br /> Certified Mail label) 30-day Grace le I return receipt service fee;and <br /> 0 A unique identifier foi SJM GRM AJW he mailpiece"Return Receipt <br /> n Electronic verification A,"or see a retail associate for <br /> delivery. assistance.For an electronic return receipt, <br /> R A record of delivery(including the recipient's see a retail associate for assistance.To <br /> COMPLETE THIS SECTION ON DELIVERY <br /> SENDER: COMPLETE THIS SECTION signature)that is retained by the Postal receive a duplicate return receipt,present <br /> 7 1 Mli I Service"for a specified period this USPSO-postmarked Certified Mail <br /> • Complete items 1,2,and 3.Also complete A. Si ri�a�tur Important Reminders., receipt to the retail associate,who will <br /> P%ent provide a duplicate return receipt for no <br /> item 4 if Restricted Delivery is desired. B You may purchase Certified Mail service with additional fee. <br /> • Print your name and address on the reverse X r-1 Addressee First-Class Mad",First-Class Package Restricted delivery service,which provides <br /> Service",or Priority Mail'service.so that we can return the card to you. f:eceived by(Printed Name) C. Date of Deli ry a Certified Mail service is notavailable for delivery to the addressee specified by name,or to the addressee's authorized agent. <br /> c <br /> • Attach this card to the back of the mailpiece, It_2 international mail. Inlude applicable postage to cover the <br /> or on the front if space permits. a Insurance coverage is not available for restricted delivery fee and endorse the <br /> D. Is delivery address different from item 19 ❑1:1 Yes purchase with Certified Mail service.However, mailpiece"Restricted Delivery,"or see a <br /> 1 Article Addressed to: If YES,enter delivery address below: ❑El No the purchase of Certified Mail service does not retail associate for assistance. <br /> change the insurance coverage automatically m To ensure that your Certified Mail receipt is <br /> Included with certain Priority Mail items, accepted as legal Proof of mailing,it should <br /> x For an additional fee,you may request the bear a USPS postmark.If you would like a <br /> Stacey Mascarenas following services: postmark on this Certified Mail receipt,please <br /> Mesa County Return receipt service,which provides you present your Certified Mail item at a Post <br /> with a record ad a <br /> P.O- Box 20000-5025 of delivery the Office-forpost rk' If dori'tne <br /> d don't <br /> Iran gtyt,tach <br /> e !,?rja1ioVstmM?e,Pon <br /> ard y return receipt or an c onic Vba 0 <br /> 4UELOJO!n,CO 81502 %P ]TROA1 is aie,affb(t to the <br /> 3. Service Type version.F,1a3a1d3PS4errma n StriPPROOMPr2lAtEpostage,and <br /> El Certified Mail® E3 Priority Mail Express- COMPIUM ro runn.381 Iesti uCQP s t e P iece. <br /> 0 Registered 0 Return Receipt for Merchandise Receipt,attach PS Form g nver, is receipt for your records. <br /> Ps Form 3800,July 2014(Reverse)PSN 7530-02-000-9047 <br /> El insured Mail 0 Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) 0 Yes <br /> 2. Article Number 7014 2120 0001 7885 2721 <br /> (Transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />