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INSPEC01568
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INSPEC01568
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Entry Properties
Last modified
8/24/2016 8:56:47 PM
Creation date
11/18/2007 8:01:18 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1982147
IBM Index Class Name
Inspection
Doc Name
MINERALS PROGRAM INSPECTION REPORT
Inspection Date
2/28/2001
Media Type
D
Archive
No
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° SENDER: <br />• Compleb items 1 end'or 2 br eddRblrFOYnlne. . <br />• • Complde item ~, •e, erd ib. <br />• Print your turns antl etltlnass on the revert d ttie form eo M w~ arl nehMn lNe <br />card to you. <br />• Atuch ads lotto b the hoot d the meilpiece, a on the betlt If specs dose not <br />~ ~7emm. <br />e Wrile'ReNm Recefpr Requesfed'm Ne mellpleco bbw dte erOcle nuriber. <br />e The Retum Receipt wiN ataw to wham the article was deNVeretl entl the tlete <br />tlelheretl. <br />3. Article Addressed to: 4a. Article <br />4b. Servke <br />I also wish to receive the <br />foNOwinp services (for an <br />extra fee): <br />1.0 Addressee's Atldress <br />2. ~ RestritYed DeUvery <br />Consult postmaster for fee. g <br />~;1~,~,~,/r+/~ ~ ^ Registeretl <br />~V r ~ oZ x.$00 l ^ Express Mail <br />~1 ^ Retum Receipt fa MerNlendise <br />,) _ ~ ~ /1 7. Date of Delivery <br />S. Received By: (Print Name) B. Addressee's Address (Only <br />~certifled <br />^ Insured <br />^ COD <br />J 0 X~,~,~ end lee is paid) ~ / n~~~/ <br />fi. Signature: (Addressee or ant) S <br />X <br />s p>aFOrm 3871, D bar f9p4 +msasae-some Domest'tC Return Rec <br />ru <br />m <br />n' DMG•1313 SMemun. Am 215, Denver, CO 80203 <br />~ / <br />[T` Postage E / 1 / l~~r\ <br />m ~ ~' ~\F <br />.A Candied Fee v PO5lmarh 9 <br />~ ~ C> Heba t Q <br />Retgm Rece~Pt Fee S~ O rv ~ <br />4 (Endorsement Requned) . ~ <br />O \ + s' o <br />p Resirlcle0 Delnery Fee [~ <br />O (Endosement Regmredi J r / \_ ~ I <br />0 Total Ponape 6 Fees <br />r- <br />-a R ~entS Name !P se P reatlv) RO ee compieled ey maieO <br />ra <br />.......................... <br />~ " ree Apr .: or ~x <br />o ....... ............... <br />,, /~ ~ /J~-~-~ <br />D ~~,y~5ia. ~ •a~/~rM/ J1iA•rT/ C..r_~ <br />f <br />T <br />
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