2018-08-28_GENERAL DOCUMENTS - M1995095

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COMPLETEe ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse � 1]Agent so that we can return the card to you. ❑Addresse B. Re a ffnte e C. Date of Deliver ■ Attach this card to the back of the mailpiece, Na _ or on the front if space permits. 1. Article Addressed to. D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑ No James Shelton 19855 Chelton Road Ramah, CO 80832 3. Service I'ilI'iIIII' II11 II 'I'.I 'I 'll ii t i'I, II ❑❑ Type ❑Priority Mail Exp re ssa Adult Signature ❑Registered Mail- Adult Signature Restricted Delivery ❑Registered Mail Restnc XCertdied Mad® Delivery 9590 9402 3488 72,'5 7580 35 ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise 2. Article Number(Transfer from service iahen ❑Collect on Delivery Restricted Delivery D Signature Confirmation El Insured Mad ❑Signature Confirmation 70 1,6 2710 0000 2904 6 519 ❑Insured Mail Restncted Delivery Restricted Delivery(over$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receip U.S. Postal Service: Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail labeq. for an electronic return receipt,see a retail CERTIFIED. ,MAIV RECEIPT Domeptic Mail Only ■A unique identfier year fi e. �•\ associate for assistance.To receive a duplicate ■Electronic cation of delivery or attempted retain receipt for no additional fee,present this T delivefy, L SPS®postmarked Certified Mad receipt to the Ln ■A record of d Id iveC[n n rec�plen s e signature) at is r med by the Postal Service"' -R stricted delivery service,which provides --D for a spec r ( d livery to the addressee specified by name,or @ r1'1 �i�S L ( aaddreesee'sauthorizedagent � 2.1 to 3.0 oz. Postage 80.$9 tmportantReminders: -2�� I0L 3— duitsignatureservice,whichrequiresthe o Certified Fee: ■You may purchase Certified Mall service w dt ignee to be at least 21 years of age(not Cr- = $3.45 First-Class Mails,Hirst-Class Package Service•, available at retail). Return Receipt Fee: $2.75 or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailabfe far requires the signee to be at least 21 years of age d international mail. and provides delivery to the addressee specified Total Postage & Fees: $7.09 •Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mad service.However,the purchase (not available at retail). of Certified Mad service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a Ell certain Priority Mad items. USPS postmark.If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your '- endorsement on the mailpiece,you may request Certified Mad item at a Post Officee'for Fu 5 the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the madpiece,apply --q - -- James Shelton You can request a hardcopy return receipt or an ap r is osta e a l iece. el� yra >at�4�oom$� , tl~�i',r��' p 19855 Chelton Road co a Form 1 , omes is 'fain Receipt,attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ra mah, CO 80832 Ps F.3800,"2015(Reverse)PSN 753a-02-000- 7 64 V # First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 3488 7275 7580 35 United States •Sender:Please print your name,address,and ZIP+4®in this box• Postal Service State of Colorado Department of Natural Resources Division of Reclamation, Mining& Safety 1313 Sherman Street, Suite 215 Denver, CO 80203 Spec ice_ 1 y C_ 2— File I'1111111rf�tllttltlrlitltlt�##fitfitr##itr�iiriiltlltll'tttell°#