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UNITED STATES POSTAL SERVICE <br />t <br />tr <br />z <br />z <br />• Sender: Please print your name, address, and ZIP+4 <br />State of Colorado RECE1Vr-v <br />Department of Natural Resources JAN 26 2011 <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Suite 215 _ pl�ision of Reclamatio , <br />Denver, CO 80203 �&Saw- <br />C-1980-002 <br />Termination of Jurisdiction <br />SL -1 <br />i,jilllllllllrll},'i' +"ITTrFl?�t pf11,rlip, <br />■ Complete items 1, 2, and 3. Also complete <br />A. Signature <br />item 4 if Restricted Delivery is desired. <br />■ Print your name and address on the reverse <br />X j 13 Agent <br />so that we can return the card to you. <br />(/ ❑ Addressee <br />■ Attach this card to the back of the mailpiece, <br />BReceived by (Printed Name) C. to ofelivery <br />or on the front if space permits, <br />t' f- U <br />1. Article Addressed to: <br />D. Is delivery address different from item 1. ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />Gunnison County Commissione <br />County Commissioner <br />200 E Virginia <br />Gunnison, CO 81230 <br />Service Type <br />❑ Certified Maile Q Priority Mali Express - <br />El Registered M 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) ?014 015 0 0 0 0 0 9138 52134 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />