Laserfiche WebLink
»~~ii»~ mum <br />FiFCEiVEa <br />~Ef; ~'~ 1999 <br />Uiwsr]n cl Minerals & Ge~lo9p <br />m <br />Q <br />a <br />0 <br />O <br />m <br />f+7 <br />V. <br />4 <br />^ Complete items 1, 2, and 3rPAeo complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />t. Amcle Adtlressetl to <br />~.~ ~S fle~(IiVEr <br />Southway Constr//uction Co., Inc. <br />117 White Pine Drive <br />Alamosa, CO 81101 <br />2 <br />Z 405 997 532 <br />US Posfal Service <br />Receipt for Certified Mail <br />.,_ __ o.~..;~~ <br />Lkc ~_ r_D ego I yzt~ <br />Southway Construction Co., lncCo.. Inc. <br />117 White Pine Drive <br />Alamosa, CO 81101 <br />i Postage $ , 3 <br />Certlfietl Fee <br />Spedal Delivery Fee <br />ResMded Delivery Fee <br />Relum Receipt Showing to <br />Whom 6 Dale Dogvaletl <br />Realm Rece'pl SMwng to whom. <br />trdte, 8 MNessee's Adores <br />TOTAL Postage 8 Fees $ <br />PosMerk or D11al(e,(, <br />i~'r 1 ~Gfq <br />®~IV t'rie`d ~~'.~ ' ..r•. <br />1=1LE:~f-gy-~(3 <br />~ITE:Paw.~~ P,~ <br />Reeeived <br />PlDV 2 `~ 1`?~?J <br />Durango Field Office <br />Olrlebn of Minerals E Gsology <br />by (Please Prinr Clearly) I B~O~ f ~ IgteryQ <br />C. Signa{ture/~ <br />X f/ `/ y~ //, ~ / ^ Agent <br />fy- (s ,~J(~~~c-. O Atldre <br />D. Is delivery address diHeren~h m item 17 O Yes <br />H YES, enter delivery address below: ^ No <br />3. Service type <br />~$ Certilied Mail ^ Express Mail <br />^ Registered ^ Return Receipt for MetchatMise <br />^ Insuretl Mail ^ C.O.D. <br />4. Restrictetl Delivery? (Fa'tra Fea) ^ Ye5 <br />PS Form 3811, July 1999 Domestic Return Receipt <br />102595-99~M~r]a9 <br />`i <br />