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• o • o <br /> r a <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired [I A <br /> ■ Print your name and address on the reverse ❑ Addddress <br /> Agent <br /> so that we can return the card to you. B. RecerJed by(P ted Name) C Date of Delrre <br /> ■ Attach this card to the back of the mailpiece, I <br /> or on the front if space permits. <br /> D Is deL,,ery address diffeient f,om item 1? Y s <br /> 1 Article Addressed to: If YES,ertei delivery addiass below <br /> Mr Mark Johnson T=[ <br /> . Service Type <br /> Bestway Concrete Company Cert,fied Mail- ❑ Priority Mail Express"' <br /> 301 Centennial Dr ❑ Registered ❑ Return Receipt for Merchand!°Milliken,CO 80543 ❑ Insured Mail ❑ Collect on Delivery. Restricted Delivery?(Extra Fee) ❑ Yes <br /> 2 Article Number 7 016 2140 0000 2346 1988 <br /> (Transfer from service <br /> PS Form 3811,July 2013 Domestic Retvn Receipt <br /> UNITED STATE st <br /> P SERVICE <br /> First-Class Mail <br /> Postage&Fees Paid <br /> LISPS <br /> PM 6 L Permit No.G-10 <br /> • Sender: Please print your name, address, and ZIP+4®in this box• <br /> STATE OF COLORADO n f M <br /> DEPARTMENT OF NATURAL RESOURCES f <br /> DIVISION OF RECLAMATION, MINING &SAFETY <br /> 1313 SHERMAN STREET, SUITE 215 t A��` \ <br /> DENVER, CO 80203-2273 Q 0 n,{ <br /> Spec! <br /> File# O C <br /> i'i=Giill=i'iiil=11'i'li'I'li='it=iliillllliilililillri'u►=i111 <br />