Laserfiche WebLink
STATE OF COLORADO <br /> DIVISION OF RECLAMATION, MINING&SAFETY <br /> Attn:Camille Mojar <br /> 1313 SHERMAN STREET, ROOM 215 <br /> DENVER,CO 80203 <br /> 341300000 .fs.r_gtre...:r1. .••i t,.v: , .• . <br /> 7018 2290 0001 8923 1076 <br /> RECEIVED <br /> MAR 1 n Wag <br /> (' . DIVISION OF RECLAMATION -15 <br /> MINING AND SAFEI ( 3. z-S- <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> , <br /> • Complete items 1,2,and 3. A. Signature <br /> X164111, IN Print your name and address on the reverse X 0 Agent <br /> so that we can return the card to you. 0 Addressee <br /> • Attach this card to the back of the mailpiece, <br /> B. Received by(Panted Name) C. Date of Delivery <br /> or on the front if space permits. <br /> . ' ' • - ^ '-delivery address different from item 1? 0 Yes <br /> • YES,enter delivery address below: 0 No <br /> Raymond Difani <br /> P.O. Box 4777 <br /> &. . <br /> Breckenridge, CO 80424 <br /> I I I'I I'I IIII III(1 11111111 111111 <br /> o diffe0 SignatureRegistered Mail'. <br /> ❑Adult Signature Restricted Delivery 0 Registered Mail Restricted <br /> Certified Mail® Delivery <br /> 9590 9402 4401 8248 9103 80 0 Certified Mail Restricted Delivery 0 Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 0 Aoirl.Niimhar ITran.cfar from service label) 0 Collect on Delivery Restricted Delivery 0 Signature Confirmatlonrm <br /> —Insured Mail 0 Signature Confirmation <br /> 7018 2290 0001 8923 1076 Insured Mail Restricted Delivery Restricted Delivery <br /> I (over$500) <br /> i ! PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />