Laserfiche WebLink
COMPLETE1 SENDER: •N COMPLETE mis sEcTION0A1 DELIvERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse X _�� ❑Addresse( <br /> so that we can return the card to you. B. Received C. D to of)Deliven <br /> ■ Attach this card to the back of the mailpiece, �. `i0d.A�1 <br /> or on the front if space permits. <br /> 1. Article Addressed to: D. Is eliveryj�d�ess differ tt from ite 1? Yes <br /> YES frenter delivery addres belo ❑ No <br /> ! <br /> Mr. Rick Domson <br /> Breese Basin Resources Inc. <br /> P O Box 181 C 3. ice <br /> Hayden, CO 81639 rtlf Mai Prigry Mail Express' <br /> ❑ Regi _❑fR2tu`rr(Receipt for Merchandise <br /> i ❑ Insured Mai '❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7p14 2120 0001 7885 6644 <br /> (Transfer from service/abed <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES POSTAL SERVICE First-Class Mail <br /> 111111 xn:D EAI_C _ tasge&Fees Paid <br /> PerFPmit No.G-10 <br /> JAR— <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 f `j <br /> File 114AaUv'i1 <br />