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DIVISION OF MINERALS AND GEOLOGY <br /> <br />CERTIFICATE OF SERVICE <br />RECEI~~F~ <br />Permit No. C-81-014 <br />NOV No. cv-97-o02 <br />MAY 0 61997 <br />piyi~i0n at Minerals «ueuw~, <br />I hereby certify that I served a copy of the foregoing NOTICE AND ORDER TO PAY FIXED PENALTY <br />on APRIL 15 , 1997 by depositing a true copy thereof, first class postage prepaid, in the <br />United States mail, to the operator at the address above, on APRIL 15 1997 <br />Certified Mail No. z 416 952 462 <br />Return Receipt Requested <br />Signature of Person Served <br />if Personal Service <br />Signature <br />Name: DANIEL I. HERNANDEZ <br />Title: 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 />By ,~p .w ~~~ .e n,ow <br />(Signature) <br />Date ~ / ~ 97 <br />