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STATE OF COLORADO <br />Division of Minerals and Geology <br />Department of Natural Resources <br />1313 Sherman Street, Room 215 <br />Denver, Colorado 80203-2273 <br />lJ f - - <br />.. .. <br />• • ~~~ ,/ 4 <br />341300000 <br /> <br />L°r,~~~\ <br />i P 436 790 0).3 <br />MAIL <br />JFjCK DICKSON <br />~)'~,~' OS FAIRVIEW DR <br />FORT COLLINS CO 80524 <br />/~ <br />SENDER: I also wish to receive the <br />. Complete name / andor 2 rot atldltlonel eervkaa following services (for fln <br />• Complete Item. 3. b, and b. <br />• Pnnt your name antl etldreae on th reverse d rhla lam so Cul we can ratum Nle <br />9%trB fBe): <br />CeN to yyau. <br />• Attach Ihie lam to Ne Imnt of ttw mellDlece, or on ea beck n apace dose rwt <br />t . ^ Addres50B'S Address <br />peanit. <br />. Write 'Rehm Reaelpl RequesYed'on the mailpiece below iM el5cle number. <br />2. ^ RBStflCfed DBIiVery <br />m Receipt will chow to whan Ne article was tlelrvered ontl the tleW <br />a <br />eb COrISUIt p051frIBSIBr fnr fBe <br />etetl <br />d . <br />3. ArBCIe Addressed to: <br />d ~ ~~~ ~~~-~ ~ ~~ <br />X <br />PS Form <br />or <br />December 1994 <br />4b, service type 5 <br />^ Registered ^ CeAilied 7E~ <br />^ Express Mail ^ Insured ~ <br />^ Retum Receipt for Merchandise ^ COD ~ <br />7. Date of Delivery <br />end fee is paid) <br />102595~p&8-0729 Domestic Retum <br />°~ ~..... <br />-: <br />-~_~ _ ~= <br /> <br />.,t;.`-_ <br />%r 1 <br />~~ <br />~ <br />, ,i , <br />a <br />~ <br />~ <br />r ~r <br />lt~ <br />•-Y. <br />1 <br /> <br />llf <br />L ] <br />1° <br />1~ <br />_`I <br /> <br />[~° <br />CA ~ <br />I` <br /> <br />~ v I <br />~ ~: <br /> y ' <br />1 ~ ( <br />' <br />~ <br /> , .~ <br /> ' <br />e4~.:o~ .aa <br />a~oo <br />I,ult~tdtltl <br /> <br />