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MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />`~` PERMIT N0. C-007-80 rt <br />C.0. N0. <br />N.O.V. N0. C-86-041 <br />I hereby certify that I served a copy of the foregoing <br />OF CIVIL PENALTY on the operator therein described by <br />upon the operator or its representative at <br />Colorado on 19 ,, orb <br />copy thereof first c ass postage prepaid in the United <br />191~r6ado, addressed to the operator at the address abo~ <br />ignature o erson erved <br />if personal service <br />Print Name and Title <br />NOTICE OF PROPOSED AMOUNT <br />_(a)* personal service <br />,b * by depositing a true <br />States mails at Denver <br />r e, o n Mai-39- ,y.,~ z ~'~ <br />Certified Mail No. P 169 876 320 <br />Return Rece/i~pt Requested <br />/` ~~ <br />igna ure <br />Michael S. Savage, Assessment Officer <br />Print Name and Title <br />* ---- Check applicable method of service. <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 />(5/85) <br />By <br />Signature <br />Date 19 <br />Oac. No. 251 <br />