Laserfiche WebLink
.r- ~ - <br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />C.O. No, C-84-168 <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT <br />OF CIVIL PENALTY on the operator therein described by _(a)* personal service <br />upon the operator or its representative at , <br />Colorado on 19 or XX b * by depositing a true <br />copy thereo first c ass postage prepaid in tthe Uni'~ States mails at Denver, <br />Colorado, addressed to the operator at the address above, on ~{bf~O-Mf~. Z! , <br />19~ <br />Certified M~ail~NO~. P •652 674 440 <br />Signature <br />Michael S. Savaoe <br />Name Printed <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by C.R.S. 34-33-123(8). <br />Operator <br />By <br />ignature <br />Date 19_ <br />(1/83) <br />Doc. No. 251 <br />