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. -:COMPLETE THIS SECTION <br /> ■ <br /> ■ Complete items 1,2,and 3. A. Si nature <br /> ■ Print your name and address on the reverse X Agent <br /> so that we can return the card to you. d r see <br /> ■ Attach this card to the back of the mailpiece, calve by Go me C. Date of Delivery <br /> or on the front if space permits. it d1 (J a <br /> 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes <br /> If YES,enter delivery address below: _ <br /> Richard Coulson <br /> Coulson Excavating Company,Inc- <br /> 3609 North County Road 13 <br /> Loveland,CO 805W <br /> (I I III II III I'I I II I IIIII I II III II II I II I I II I III 3. Service Type ❑Priority Mail Express© <br /> ❑Adult Signature ❑Registered MailTM <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricte <br /> ❑Certified Mail® Delivery <br /> 9590 9402 2053 6132 7836 24 ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(transfer from Cervio sar an ❑Collect on Delivery Restricted Delivery 0 Signature Confirmation- <br /> 7 014 2120 0001 7885 4 015 gyred Mail ❑Signature Confirmation <br /> gyred Mail Restricted Delivery Restricted Delivery <br /> r$500) <br /> 'S Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> U9P$,TVG# <br /> Firs lass Mail <br /> Postage&Fees Paid <br /> USPS <br /> Permit No.G-10 <br /> 9590 9402 2053 6132 7836 24 <br /> United States •Sender:Please print your name,address,and ZIP+4®in this box* <br /> Postal Service State of Colorado <br /> Department of Natural Resources <br /> Division of Reclamation, Mining& Safety <br /> 1313 Sherman Street, Suite 215 <br /> Denver, CO 80203 .. <br /> M-2005-033 <br /> 30-day Grace Itr <br /> JLE WHE AJW <br /> 3—.2224316S ilrlilrlrl�lt♦r►1�1��rrJttlillrll�llfilet)#loll,lil��l��li'r�rirrl� <br />