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DIVISION OF MINERALS AND GEOLOGY <br />RF(',FIVEr' <br />DEC D 4 1995 CERTIFICATE OF SERVICE <br />Permit No. C-82-057 <br />DivieionofMmarain..l:oWo9Y NOV No. G9S-023 <br />NOU 2 0 R~~'~ <br />I hereby certify that I served a copy of the foregoing NOTICE AND ORDER TO PAY FIXED PENALTY <br />on the operator therein described by depositing a true copy thereof, first class postage prepaid, in the <br />United States mails at Denver, Colorado, addressed to the operator at the address above, on <br />November 16, 1995. <br />Certified Mail No. P 296 797 353 <br />Return Receipt Requested <br />Signature of Person Served <br />if Personal Service <br />Name and Title <br />S <br />Na~: David A. Berry <br />Title: Assessment Officer <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement conference as permitted by <br />C.R.S. 34-33-123(8). <br />~u~~ ~ ~ ~ <br />Operator <br />B L -l ~~ ~ ~~°_-__` <br />Y <br />(Signature) <br />Date //-30- FS- <br />~BJ WISENECA.PCP <br />