2017-01-04_GENERAL DOCUMENTS - M1999022

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UNITED STATES POSTAL SERVICE First-Class Mail Postal Postage&Fees Paid LISPS CERTIFIED a RECEIPT Permit No.G-10 Domestic Mail Only r•i r- • Sender: Please print your name, address, and ZIP+4®in this box• o-. - cc - $0.465 State of Colorado Postage: $3.300 Department of Natural Resources rq Division of Reclamation,Mining&Safety C3 Return Certified Fee: J� 2 j00 G 9.3. _ C1 (Endorseme Return Receipt Fee C Restricted M-1999-022 (Endorseme, ; .465 1313 Sherman Street,Room 215 C3 �e�; Denver,CO 80203 Total Postage & File r•q Total Postage&Fees I� ,! nj Mr Eddie � Sent To Clayton - sireeiaiipi. Eddie Clayton — P_ or PO Box No. PO BOX 2 City Sfe1e,-y1W+a - CO 81136 ---- Hooper, illii}"li'}l�"i}}ail'i}ilili'li�'i}i}ii,li,iili„i}lit},�ii, per, 'PS Form 3800,July 2014 See Reverse for Instructions Certified Mail s�yiip provides the following benefits: ■A Certified Mail receipt t�Va the mailpiece;include applicable postage to Certified Mail label). ' e return receipt service fee;and ■A unique identifier for yfj "Return Receipt ■Electronic verification of de M_1 999_022 a retail associate for delivery. an electronic return receipt, COMPLETE • • • • . ■A record of delivery pncludii,y.., .......1 receive for assistance.To signature)that is retained by the Postal receive a duplicate return receipt,present Services for a specified period. this USPS°-postmarked Certified Mail g ■ Complete items 1,2,and 3.Also complete A. ure receipt to the retail associate,who will item 4 if Restricted Delivery is desired. ❑Agent important Reminders: , provide a duplicate return receipt for no ■ Print your name and address on the reverse Xv ■You may purchase Certified Mail service with additional fee. ❑Addressee First-Class Mail®,First-Class Package Service®or Priority Mail®service. Restricted delivery service,which provides so that we Can return the Card to you. B. Received b (Printed N ate of Delivery delivery to the addressee specified byname, ■ Attach this card to the back of the mail piece, �?e, ■Certified Mail service is notavailable for or to the addressee's authorized agent. or on the front if space permits. p �' I n C. D i— international mail. Include applicable postage to coverthe D. Is delivers ad ess gifferent fro (tern 1? ❑Yes ■Insurance coverage is notavailable for restricted delivery fee and endorse the 1. Article Addressed to: purchase with Certified Mail service.However, mailpiece"Restricted Delivery,"or see a If YES,e�lter elivery address b)IMv: ❑No the purchase of Certified Mail service does not retail associate for assistance. change the insurance coverage automatically ■To ensure that your Certified Mail receipt is included with certain Priority Mail items. accepted as legal proof of mailing,it should ■For an additional fee,you may request the bear a USPS postmark.If you would like a following services: postmark on this Cerbfied Mail receipt,please Return receipt service,which provides you present your Certified Mail item at a Post Mr.Eddie Clayton with a record of delivery[including the Office-for postmarking.If you don't need a Eddie Clayton recipient's signature).You can request a postmark on this Certified Mail receipt,detach PO Box 2 3. Servi ype hardcopy return receipt or an electronic the barcoded portion of this label,affix it to the Hooper, CO 81136 ertified Mail ❑�.Wrn ail Ex rests'" vers pry�9�Q�et(c�W 1� a mailpiece,apply appropriate postage,and ® P comFlfere PS h�rrfi3$1T mes rc eCum St deposit the mailpiece. [I Registered eceiptforMerchandise Recey~FLR038012®tp IMPORTANT:Save this receipt for your records. ❑ Insured Mail ❑Collect on Delivery PS Form 3800,July 2014(Reverse)PSN 7530-M-000-9047 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7 014 2120 0001 7869 5 717 (Transfer from service labf—, PS Form 3811,July 2013 Domestic Return Receipt