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i <br /> MINED LAND RECLAMATION DIVISION <br /> CERTIFICATE OF SERVICE <br /> PERMIT NO. :C-81-038 <br /> C.O. NO. : <br /> N.O.V. NO. :C-93-142 <br /> I hereby certify that I served a copy of the foregoing NOTICE OF <br /> PROPOSED AMOUNT OF CIVIL PENALTY on the operator therein described <br /> by depositing a true copy thereof first class postage prepaid in <br /> the United States mails at Denver, Colorado, addressed to the <br /> operator at the address above, on November 12, 1993 . <br /> Certified Mail No. : P 296 527 465 <br /> Return Receipt Requested <br /> 42�/d'4eg // <br /> Signature of Person Served lgna ure) <br /> (If personal service) <br /> Larry P. Routten, Assessment Officer <br /> Print Name and Title Print Name and Title <br /> REQUEST FOR CONFERENCE <br /> The operator above described hereby requests an assessment <br /> conference as permitted by C.R.S. 34-33-123 (8) . <br /> Operator <br /> By <br /> (Signature) <br /> Date , 19_ <br />