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i~ '~ <br />STATE OF <br />MINED LAND RECLAMATION DIVISION <br />Department of Natural Resources <br />t 313 Sherman St., Room 215 <br />Denver, CG 80203 <br />303 866-3567 <br />FA%:303 832.8106 <br />pF'COrO <br />t~~ ~9Q <br />Hem, O <br />~,~ r <br />-r y.. <br />Roy Romer. <br />Governor <br />Fred R. Banta. <br />Division Director <br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-021 <br />C.O. NO.: <br />N.O.V. NO.: C-91-025 <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 26, 1991, <br />Signature of Person Served <br />if personal service <br />Print Name and Title Assessment Officer <br />" ---- Check applicable method of service. <br />Certified Mail No.: P 427 450 861 <br />Return Receipt Requested <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 />By <br />LPR/eke <br />gnature <br />a <br />(Signa <br />Date <br />19_ <br />9671E <br />