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COMPLETE • DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. ' t e <br /> item 4 if Restricted Delivery is desired. �101 <br /> ■ Print your name and address on the reverse ee <br /> so that we can return the card to you. B. Received by(Printed Nam 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: A No <br /> Donald R Hart <br /> 3500 Clear Fork Rd. <br /> Crawford, CO 81415 3. Service Type <br /> ICI Certified Mail® ❑Priority Mail Express' <br /> ❑Registered ❑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 labeg 7 014 2120 0001 7869 7841 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES POSTAL SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> LISPS <br /> Permit No.G-10 <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 Spec ► ?K-- <br /> �J-� /W"" File t 1'T o`� <br /> 11li'lilldiilh Ili lilh11 ill,i,J111111iii'I111111iiiii'11i11h <br />