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m Senl <br />_W <br />t Srce <br />L~ <br />m <br />PO <br />O i <br />~ Pos~a <br />Cen,n <br />4 <br />y Spec~a <br />a <br />Z 416 942 897 <br />s~ ~ <br />No Insurance overage Provider~j <br />,,,~,~°;a~a Do not use for International MaiG <br />(See Reverse) CD <br />antlNOLAND RE <br />1 DRA4rFR Q(1 <br />'~~aie an0 ZiP C°°e <br />~ Fee <br />Deiwew Fee <br />Yl ~~.eiy r<p ^- <br />Rewm geceipi Snpw,ng - <br />m Wnpm 8 Dare Dehverea <br />Relwn Receipt Snowing is <br />Oale, one A~rJ~eSSee's 4pa <br />8 Fee!' <br />~~ <br />~ ` ~.` ;v) <br />r. a <br />~ 7u <br />"~-II CO <br />C <br />C <br />(U <br />_C <br />T <br />\~ <br />~., SENDER: <br />v Complete ilema 1 anNOr 2 fa additional eerNCae. <br />I eISO WISh f0 teCelVe fhb <br />D •Complete items 3, da. and db. ~ fONOWIng SBrVICea (fOr an <br />~ •Pdm your name end address on the reverse of this farm so Nat we can velum This BXlra fee): <br /> <br />~ card to you. <br />•Atleeh Nis form to the hoof pl the mailpieca, or on the bade if space does not <br />~, ^ AddrOSSBe'S Address 6 <br />~ <br />Z <br /> <br />o permit. <br />•Wnta'Aelum Aeceiyl Aeques7ed' on the maApece below the enicl <br />e number. <br />2. ~ Restdcted Delivl3ry p <br />y <br />~ eThe Retum Receipt will show to whom the aside was delivered end the date <br />~ delivered. Consult postmaster for tee. <br />0 <br /> 3. Article Addressetl to: - 4a. Arficle Number <br />4 VIRGINIA DEPT OF NATURAL Z 416 942 897 E <br />E RESOURCES 4b. Service Type m <br />u DIVISIbN OF MINED LAND RECLAMTN ~ Registered ®Certified w <br /> P U LRA?dER 900 ^ Express Mail ^ Insured n <br /> BIG STONE GAP VA 242]9 ^RetumReceiptforMerchandise ^ COD <br />o 7. Date of Delive <br /> S- 2 ~ <br />r <br />° <br /> 5. Received By: (PAnf Name) 8. Addressee's Address (Only i/requested ~ <br /> and /ee is paid) i <br /> <br />g ti. slgnamre: (noaressee onager <br />n <br />Ps Form 3811, December 1994 UOrtI05tIG HEtURI HBC@IPt <br />Ot <br />