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COLORADO <br />Division of Reclamation, <br />Mining and Safety <br />Department of Natural Resources <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203-2243 <br />341300000 <br />Calvin <br />Kelley' <br />6201 N <br />Golder <br />7018 2290 0001 8923 5814 <br />7018 2290 0001 8923 5814 <br />■ Complete items 1, 2, and 3. <br />■ Print your name and address on the reverse <br />so that we can return the card to you. <br />■ Attach this card to the back of the maiiplece, <br />or on the front if space permits. <br />Calvin Kelley <br />Kelley Trucking, Inc. <br />6201 M cI ntyre <br />Golden, CO 80403 <br />U <br />B. Received by (Printed Name) <br />© Agent <br />_ ❑ Addressee <br />C. Date of Delivery <br />D. Is delivery address different from Item 1? ❑ Yes - - If YES, enter delivery address below: ❑ No <br />i <br />II I IIIIII Illi ltl l llllll lllll lllllll 1111 1111111 El dull naWre U t Mail <br />CI Adult sfgnatura 1] Registered Ma11TMr <br />❑ Certifie11 Adult d Mail® ReeWed Deltvery ❑ R= <br />ig 5tefed Mall Restricted <br />De <br />9590 9402 4898 9032 9070 69 ❑ certified Mail Restrkted "�"�ef�YY <br />DetNery C]RetumReceiptfor <br />Ci tbllect on Delivery Merchandise <br />1) AWA. A!,—S..e. fry fn frn.n ean.lro falw!! ❑ COuect On Delivery ReWated Delivery ❑ Signature CAnfInnatlonym <br />7 018 2290 0001 8923 5 814 MMall Reswoted Delivery siiaesW d�Dei v d°° <br />PS Form 3811, July 2015 PSN 7530-02-000-9053 • Domestic Retum Receipt <br />