2017-02-07_GENERAL DOCUMENTS - P2014017

• Permit No: P2014017
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 2/7/2017
• Doc Name: Certified Mail Receipt
• From: DRMS
• To: Kenneth Schaaf
• Media Type: D
• Archive: No

UNITED STATE:S'ObSW'SEKrWE�­­ &Fde4:
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U.S. Postal Service TI
CERTIFIED MAIL@ RECEIPT a Sender: Please print your name, address, and ZIPW in this box
•
Ln Domestic man only
State of Colorado
to Department of Natural Resources
CO
Cc Postage: $0.465" Division of Reclamation, Mining&Safety
Certified Fee: $13W: 1313 Sherman Street, Suite 215
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Return Receipt Fee: $2.700 40- Spec
C3 Denver, 80203 -,Il
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E3 '4 6 File 1o.;z-aiqa17
(L Total Postage & Fee:
M $6.46
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Sent To
Mr. Kenneth Schaaf
C3 1205 H Lane ............
or PO Box No.
City State,ZlP+4---- Delta, CO 81416
Certified Mail service provides the following benefits:
a A Certified Mail receipt(tSPMn of theS30"t matipiece;Include applicable postage to
Certified Mail label). ne return receipt service fee;and
n A unique identifier for yof H;epiecep 90"Off.-le the mallplece"Return Receipt
in Electronic verification of delivery or attempted riviii V or see a retail associate for
delivery. 5 L.I assistance.For an electronic return receipt,
■A record of delivery(Including the recipient's see a retail associate for assistance.To
signature)that is retained by the Postal receive a duplicate return receipt,present
Service®for a specified period. this USPS11-postmarked Certified Mail
receipt to the retail associate,who will
Important Reminders provide a duplicate return receipt for no
a You may purchase Certified Mail service with additional fee.
First-Class WHO,First-Class Package
Service",or Priority Mail"service. -Restricted delivery service,which provides
delivery to the addressee specified by name,
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY r Certified Mail service Is notavallable for or to the addressee's authorized agent.
international mail. Include applicable postage to cover the
• Complete items 1,2,and 3.Also complete A. Signature ■A Insurance coverage Is not available for restricted delivery fee and endorse the
purchase with Certified Mail service.However, mail piece"Restricted Delivery,"or see a
item 4 if Restricted Delivery is desired. 0 Agent the purchase of Certified Mail service does not retail associate for assistance.
• Print your name and address on the reverse X ✓ 13 Addressee change the insurance coverage automatically w To ensure that your Certified Mail receipt is
- - - - -— 11MULIM with certain Priority Mail items. accepted as legal proof of mailing,it should
so that we can return the card to you. B. C. Date of Delivery 0 For an additional fee,you may request the bear a USPS postmark.If you would like a
• Attach this card to the back of the mailpiece, following services: postmark on this Certified Mail receipt please
or on the front if space permits. -Return receipt service,which provides you present your Certified Mail item at a Post
D. Is delivery address different from item 1? 11 Yes with a record of delivery(including the Office'for postmarking.If you don't need a
1. Article Addressed to: If YES,enter delivery address below: 11 No recipient's signature You can request a postmark on this Certified Mail receipt,detach
hardeop W9n1-W1*&herrfttrWpd portion of this label,affix it to the
ol,
version.For a hardcopy return receipt, mai piece,apply appropriate postage,and
complete PS Forr006nV&VPWvW203deposft the mailplece.
Receipt;attach PS Form 3811 to your IMPORTANT.'Save this receipt for your records.
PS Form 3800,July 2014(Reverse)PSN 7530-02-000-9047
Mr. Kenneth Schaaf
1205 H Lane 3. Service Type
Delta, CO 81416 a Certified Mail® 13 Priority Mail Express"
0 Registered 171 Return Receipt for Merchandise
El Insured Mail 0 Collect on Delivery
4. Restricted Delivery?(Extra Fee) 11 Yes
2. Article Number 7014 2120 0001 7885 6675
(Transfer from service label)
PS Form 3811,July 2013 Domestic Return Receipt