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III IIIIIIIIIIIII III <br />DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-022 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-92-033 <br />RE~EfVEI:` <br />DEG 9 1992 <br />DIV15IUiv ur <br />PINERALS & GEO~i3~~Y <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT <br />OF CIVIL PENALTY on the operator therein described by depositing a true copy <br />thereof first class postage prepaid in the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on November 25, 1992. <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />Certified Mail No.: P 860 170 628 <br />Return Receipt Requested <br />~~~Signature) <br />Larry P. Routten, Assessment Officer <br />Print Name and Title <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by C.R.S. 34-33-123(8). <br />Operator <br />`8y <br />(Signature) <br />/Date ~.Z/ 7 19 %2-. <br />LPR/ern <br />5493E <br />