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2017-06-14_REVISION - C1994082
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2017-06-14_REVISION - C1994082
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Entry Properties
Last modified
7/18/2017 9:41:17 AM
Creation date
7/18/2017 7:12:15 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1994082
IBM Index Class Name
Revision
Doc Date
6/14/2017
Doc Name Note
(Inspection Notiifcation)
Doc Name
Certified Mail Receipt
From
John Patrick & Linda Patrick Trust
To
DRMS
Type & Sequence
SL6
Email Name
JDM
DIH
Media Type
D
Archive
No
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UNITED STATEO�RE I 1- 5 "--0 ` ' ~ t1i <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-Aierman Street, Suite 215 <br />Denver, CO 80203C-199 <br />■ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />■ Print your name and address on the reverse <br />so that we can return the card to you. <br />■ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />John Patrick <br />Linda Patrick Trust <br />16038 Clover Ln <br />Dubuque, IA 52002 <br />2. Article Number <br />(transfer from service h <br />PS Form 3811, July 2013 <br />4 <br />-082 <br />SL -6 <br />Insp Notification <br />- -- � - <br />jdmlahh <br />A. Signat��m) n / <br />X �L)1 ' /" 13 Agent <br />--( _ -0 Addressee <br />B. ceived by frr ted Name) C. Date of Deliv ry <br />uJlt�l rA—w2 nz 16, )2 j 1 <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: U No <br />3. Service Type <br />❑ Certified Mail® ❑ Priority Mail Express - <br />El Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />7014 0150 0000 9138 5518 <br />Domestic Return Receipt <br />
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