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SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. signature <br /> item 4 if Restricted Delivery is desired. •X� Agent <br /> ■ Print your name and address on the reverse ❑Addressee <br /> so that we can return the card to you. B. Received by(PrintegName) C.Pate of Delivery <br /> ■ Attach this card to the back of the mailpiece, ,kid,- a d�c <br /> or on the front if space permits. 7 <br /> D. Is delivery address different from item 1? El Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> Lynn M Black " <br /> San Miguel County <br /> 3. <br /> P O BOX 10 ER Certified <br /> Type <br /> Certified Mail® ❑Priority Mail Express"' <br /> Telluride CO 81435 ❑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 label) 7 014 2120 0001 8040 0774 <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 So 3',,1Cr 'CSpec L:" <br /> File M"*113 <br /> Fj�IIFiIiil�If„liiiiFiiF(iFiFFiIi F�Fi:FiFllll iil;l°{llFilifiiiil <br />