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USPS TRACKWG# <br /> t , f I Itl4�r�tltr !I �! ittr�j First-Class Mail <br /> Postage&Fees Paid <br /> USPS <br /> Permit No.G-10 <br /> 9590 9402 2053 6132 7814 91 <br /> United States •Sender:Please print your name,address,and ZIP+4®in this box;, <br /> Postal Service State of Colorado <br /> Department of Natural Resources <br /> ion of Reclamation, Mining&Safety <br /> RECE Sherman Street, Suite 215 <br /> 4�nver,CO 80203_ C- 1 A41 <br /> 7 J 198 <br /> SL-11 <br /> 0l%StCN of MW—"— CCW►AHH <br /> twt`�a'VCa i� <br /> inspection Notificatio <br /> COMPLETE THIS SECTION ON DELIVERY <br /> SENDER: COMPLETE THIS SECTION <br /> A. Signature <br /> ■ Complete items 1,2,and 3. ❑Agent <br /> ■ Print your name and address on the reverse X ❑Addressee <br /> so that we can return the card to you. B. Received b (Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, �� <br /> or on the front if space permits. h <br /> 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes <br /> If YES;enter delivery address below: ❑ No <br /> Brant & Carol Harrison <br /> Providence Place, Inc. _ <br /> 860 Rapid Creek Road <br /> Palisade , CO 81526 <br /> 3. Service Type ❑Priority Mail Express® <br /> O Adult Signature ❑Registered Mail"I <br /> II 1111111 1111 I'I I II I'I�II I II III II I I"III I'�'II ❑Adult Signature Restricted Delivery ❑Re>�istered Mail Restricted <br /> ❑Certified Mail® Delivery <br /> 9590 9402 2053 6132 7814 91 ❑Certified Mail Restricted Delivery O Return <br /> Receipt for <br /> ❑Collect on Delivery ❑Signature Confirmation TM <br /> ❑Collect on Delivery Restricted Delivery Q Signature Confirmation <br /> 2. '?016 2 710 0000 2965 4 813 0 Insured Mail Restricted Delivery <br /> ❑insured Mail Restricted Delivery <br /> -- (over$500) <br /> PS Form 3811, July 2015 PSN 7530-02-000-9053 <br /> Domestic Return Receipt <br />