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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse ❑A ent <br /> so that we can return the card to you. Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Realved by(Printed Name) l C. 15ate of Delivery <br /> or on the front if space permits. f/C/r �0, 4, <br /> 1. Artiplw Addressed to: D. Is del' ery addr n t Yes <br /> If YES,enter de elow: ❑ No <br /> Mr. Wayne Dorband <br /> Colorado Quarry 1 LLC, OCT O`Z0,18 <br /> 901 S. CR31 M7,00�j0� <br /> Berthoud, CO 80513 DIVISION OF RECLAMATION <br /> MININGAND SAFETY <br /> II I�III'I I'�I I'I�I) I'I II� I I I I I'I II II I I III 3. Service Type k Ete <br /> ❑Adult Signature ❑Regi T- <br /> e <br /> Reg <br /> istered Mail <br /> MaiITM <br /> ❑Adult Signature Restricted Delivery ❑Registered Mad Restricted <br /> f9.Certified Maile Delivery <br /> 9590 9402 3488 7275 7558 36 ❑Certified Mail Restricted DeliveryOCT 171F!ft=for <br /> ❑Collect on Delivery M�k <br /> 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7 016 2 710 0000 2904 6243 ❑Insured Mail Restricted Delivery <br /> (over$500) <br /> PS Form 3811.July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />