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DIVISION OF MINERALS AND GEOLOGY NOV 2 0 R~Crtg <br />RFr,FivF~ <br />DEC 0 4 1995 <br />pivieion of Minara~o u Gooiogy <br />CERTIFICATE OF SERVICE <br />Permit No. C-82-057 <br />NOV No. C-95-023 <br />I hereby certify that I served a copy of the foregoing NOTICE AND ORDER TO PAY F1XED 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 />David A. Berry <br />Assessment Officer <br />Name and Title <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 />,/ /// ~ <br />Operator <br />(Signature) <br />Date <br /> <br />~eiw~sern:cn.rcr <br />