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UNITED STATES,VIbIFa'hMK%4-.-4 1E First-Class Mail <br /> N-M Postage&Fees Paid <br /> USPS <br /> Permit No.G-10 <br /> i <br /> • Sender: Please print your name, address, and ZIP+4®in this box* <br /> State of Colorado <br /> Department of Natural Resources <br /> Division of Reclamation,Mining&Safety <br /> 1313 Sherman Street, Suite 215 <br /> Denver, CO 80203 - M-199e-077 MV-2016-066 <br /> Notice of Violation <br /> LJW GRIM AJW <br /> • • DELIVERY <br /> COMPLETE • • <br /> ■ Complete items 1,2,and 3.Also complete A. Sign ture <br /> gent <br /> item 4 if Restricted Delivery is desired. X - 0 Addre <br /> ■ Print your name and address on the reverse ❑Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: 11 No <br /> Rob Englehart <br /> Montezuma County ' <br /> 1 680 yolores Road i <br /> Crt� _�z�� 3. Service Type <br /> Certified Mail® ❑Priority Mail Express- <br /> El Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7014 2120 0001 7885 2837 <br /> (Transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />