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SENDER' . SECTION COMPLETE THIS SECTION ON DELIVERY
<br /> ■ Complete items 1,2,and 3.Also complete A. SignatUre SAS.
<br /> item 4 if Restricted Delivery is desired. er�k
<br /> ■ Print your name and address on the reverse X ❑A resse
<br /> so that we can return the card to you. . Received by(Printed Na e� +Date of 6elive
<br /> ■ Attach this card to the back of the mailpiece, a .�
<br /> or on the front if space permits. cA
<br /> 1. Article Addressed to: D. Is delivery address different m 1? ❑Yes
<br /> If YES,enter delivery address el amp I r.C] No
<br /> Lee Roy and Marlene J Rothe
<br /> 19727 Factory St 3. S rviceType
<br /> Sterling, CO 80751 WCertifiedMail® ❑Priority Mail Express-
<br /> ❑Registered ❑Return Receipt for Merchandis
<br /> ❑Insured Mail ❑Collect on Delivery
<br /> 4. Restricted Delivery?(Extra Fee) ❑Yes
<br /> 2. Article Number 7014 2120 0001 8040 0613
<br /> (transfer from service label}
<br /> PS Form 3811,July 2013 Domestic Return Receipt
<br /> Certified Mail service provides the following benefits:
<br /> ■A Certified Mail receipt(this portion of the C>I mailpiece;include applicable postage to U.S. Postal Service'"
<br /> Certified Mail label. n cover the return receipt service fee;and CERTIFIED MAILP RECEIPT
<br /> ■A unique identifia8pe#mailpiece. +I_endorse the mabiece"Return Receipt
<br /> ■Electronic verification of delivery or attempted Requested,"or see a retail associate for MDomestic Mail Only
<br /> derive y� ,rye p� / sistance.For an electronic return receipt, r3
<br /> ■A record of delivelyl�iIdfli lgSh¢2gc,p;�di`S o` e a retail associate for assistance.To ,�
<br /> signature)that is retained by the Postal reCeSv .
<br /> 6 8 duplicafe return receipt,present p
<br /> Service®for a specified period. this USPS postmarked Certified Mail ,� „ :t, a i J
<br /> receipt to the retail associate,who will p ' ' a ` -�
<br /> Important Reminders. provide a duplicate return receipt for no :I- �7 �'
<br /> ■You may purchase Certified Mail service with additional fee. Postage $ 3 U
<br /> First-Class Mail®,First Class Package -Restricted delivery service,which provides CO '
<br /> Service®,or Priority Mad®lservice. delivery to the addressee specified by name, Certified Fee ?.
<br /> ■Certified Mail service is not available for or to the addressee's authorized agent r i Pock
<br /> international mail. Include applicable postage to cover the 0 ReturnReceipt Fee j `
<br /> ■Insurance coverage is notavailable for restricted delivery fee and endorse the C3 (Endorsement Required) L ' O 2� e
<br /> purchase with Certified Mill service.However, mailpiece"Restricted Delivery,"or see a 0
<br /> the purchase of Certified Mail service does not retail associate for assistance. Restricted Delivery Fee
<br /> change the insurance cov@ra a automatically ■ y p (Endorsement Required)
<br /> 9 d 9 Y To ensure that our Certified Mail receipt is � tcG
<br /> included with certain Priority Mail items. accepted as legal proof of mailing,it should Q Q
<br /> ■For an additional fee,you Inay request the bear a USPS postmark If you would like a rq Total Postage&Fees s 6, 8 J �_, +�,,•
<br /> following services: postmark on this Certified Mad receipt,please ru -
<br /> -Return receipt service,Which provides you present your Certified Mad item at a Post Sent To
<br /> with a record of delivery(including the Office"for postmarking.If you don't need a �
<br /> recipient's signature).Yop can request a postmark on this Certified Mail receipt,detach
<br /> hardcopy return receipt Or an electronic the barcoded portion of this label,affix it to the 0 Stieei&AE Lee Roy and Marlene J Rothe
<br /> version.For a hardcopy return receipt, mailpiece,apply appropriate postage,and or PC)Box
<br /> A � PO r e qPf 80203 19727 Factory St
<br /> Cdy,state.
<br /> PS Form 3800,July 2014(Re;erne)PSN 7530-02-000-9047 B B fdq for your records. Sterling, CO 80751
<br /> UNITED STATES-P.MT#t'AERVICE
<br /> First-Class Mail
<br /> Postage&Fees Paid
<br /> USPS
<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 !QOA
<br /> Denver,CO 80203 Spec e-Ak
<br /> File n11�g5 Gt-7
<br /> nr,1t11f1IrIr,I�Ir,IIIr�,rinlu��,II)IIIr It,llr lit r,111111fl111
<br />
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