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e • SECTION • ' • ' <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 �' �'L L�' ❑Addresse <br /> so that we can return the card to you. B. Received by(Printed Name) C Date of Delive <br /> ■ Attach this card to the back of the mailpiece, �! — <br /> or on the front if space permits. <br /> D Is delivery address different from item 1? ❑Yes <br /> 1 Article Addressed to If YES enter delivery address below ❑ No <br /> VIR LOUTS K GiRODO <br /> SAN JLA_N COUNTY 3. Service Type <br /> 15:2 GREENS ST ❑Certified Mail- ❑ Priority Mail Express" <br /> P.O.BOX 466 ❑ Registered ❑ Return Receipt for Merchandie <br /> S1LVERTON.CO S!433 ❑ Insured Mail ❑ Collect on Delivery <br /> 4 Restricted Delivery?(Extra Fee) ❑ Yes <br /> 2. Article Number l% / �7 /' /`1--f ( -7 q 7 2 <br /> (Transfer from service label) ( �(f / G V lJW l <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> UNITED STATES POSTAL SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> LISPS <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 ,^ <br /> DENVER, CO 80203-2273 <br /> Spec. y <br /> File# <br /> 'llllli'llliIi;1;1;ih1lljiI mill;iii;ll'tili{ilil;;1'Ill iddil <br />