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UNITED S `�E'} <br />print your name, address, and ZIP+4® in this box* <br />okKV Sa'r .' <br />& <br />dc' <br />ate of Colorado <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Suite 215 - <br />Denver, CO 80203 C-1996-083 <br />SL -2 <br />Proposed Dee <br />jdm/dih <br />r- -- <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />■ Print your name and address on the:reverse <br />so that we can return the card to you. <br />■ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Delta Coun mmissioners <br />County Con sioner <br />501 Palmer reet, #227 <br />Delta, CO 81416 <br />A. Signature p Agent <br />q <br />X`; . `1 n I_ .. L— 0 Addressee <br />B. Received by (Printed Name C. Date of Delivery <br />D. Is delivery address different from item 1? 0 e <br />If YES, enter delivery address below: <br />3. Service Type <br />❑ Certified Mail® ❑ Priority Mail Express' <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) F-1 Yes <br />2. Article Number . 4 0150 pppp 9138 516? <br />(Transfer from service labeQ <br />PDomestic Return Receipt <br />S Form 3811, July 2013 <br />