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2021-07-29_REVISION - M2012016
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2021-07-29_REVISION - M2012016
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Entry Properties
Last modified
12/28/2024 12:45:09 PM
Creation date
8/2/2021 6:32:16 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2012016
IBM Index Class Name
REVISION
Doc Date
7/29/2021
Doc Name
Request For Surety Release
From
Puckett Land Co.
To
DRMS
Type & Sequence
SL1
Email Name
ACY
THM
Media Type
D
Archive
No
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COMPLETESENDER: COMPLETE THIS SECTION ��—� a13 <br /> c <br /> � c1 <br /> ■ Complete items 1,2,and 3.Also complete A. Signature 7 <br /> * N O M <br /> item 4 if Restricted Delivery is desired. X ❑Agent O O Cam, r— <br /> ■ Print your name and address on the reverse ❑Addressee O "* M 0 <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery M 3 7 Op. <br /> ■ Attach this card to the back of the mailpiece, < p W 0or on the front if space permits. — CD O <br /> D. Is deliveryaddress different from item 1? El Yes to o C[)tT <br /> 1. Article Addressed to: If YES,enter delivery address below: El No M n <br /> O .d <br /> Division of Reclamation Mining & Safety n <br /> 1313 Sherman St, Rm 215 00 W <br /> Denver, CO 80203 <br /> Service Type —' <br /> %certified Mail ❑ Express Mail <br /> 13 III 111111 <br /> IN III 11111111 <br /> TIN 111111 ❑ nsuredrMail ❑C.O.D.Receipt for Merchandise <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7011 35�0 oaoo 1J549 6847 <br /> (transfer from service label) <br /> d <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 1 <br /> i <br /> 1 <br /> < � <br /> < u' �' CA <br /> CC 0 <br /> W ' a. C W <br /> Ln <br /> �—--- <br /> �.�-- <br /> � (nc9 41 Orvi <br /> � o <br /> w rt � 3 <br /> i <br /> o _ <br /> N 0 <br /> CT L = <br /> 03 <br /> 0 <br /> Ma <br /> CO) <br /> C— <br /> { <br /> Z O r— M �x <br /> G)-n C) <br /> �X <br /> c*>cn <br /> m <br /> pg� <br /> did R2305E124825 C <br /> !� N O O O-n <br /> V O -4 xp - (7 <br /> Z C)�N <br /> 0 N ,..�O ��T -00 n .D Mo <br />
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