1991-10-07_PERMIT FILE - M1991123 ‎(5)‎

• Permit No: M1991123
• IBM Index Class Name: Permit File
• Doc Date: 10/7/1991
• Doc Name: REGULAR OPERATION 112 RECLAMATION PERMIT APPLICATION FORM
• Media Type: D
• Archive: No

SENDER: I also wish to receive the
Complete items 1 and/or 2 for additional services.
• Complete items 3, and 4a & Is. following services (for an extra
• Print your name and address on the reverse of this form so fee):
that we can return this card to you. 1. ❑ Addressee's Address
.o ( Ly Q wq • Attach this form to thr• front of the mailpiece, or on the
CCV L `� back if space does not permit.
N a o r Cp �-! ✓' • Write "Return Receipt Requested" on the mailpiece next to 2. ❑ Restricted Delivery
C ` the article number. Consult postmaster for fee.
aj o © � ` 'O (fy J� 3. Article Addressed to: 4a. Article Number
V Longmont SCS District P 801 345-695
_`o y "-f 959 Nelson Road 41b. Service T,yp
d w ; d Box �A ❑ Registered)., ❑ Insured
o ° v Q a$ ac c. Certified l ❑ COD
o¢ o Longmont, CO 80501 C
O -` M. m �C / xpress aril ❑ Return Receipt for
b d o o y a z m m H • m lJ`• T + Merchandise
d z o d c d o _ 9 , 7. Data of Delivery
ka g E L' 5. Si nature lAddr ss eel 8. Addressee's Addre (Only it requested
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0661 SUN''0)SE w10j Sd nN
6. Tignature (Agent)
91-156A 9/26/91
- — -- PS Form 3811, October 1990 *U.S.GPO:1ss0--2M.861 DOMESTIC RETURN RECEIPT
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