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(~'e <br />•' •. <br />i/ <br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT N0. C-81-048 <br />C.O. NO. <br />N.O.V. N0. C-86-069 <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 _(a)* personal service <br />upon the operator or its representative at ~ , <br />Colorado on 19 or b * by depositing a true <br />copy thereof first c ass postage prepaid in the Unites States mails at Denver, <br />Colorado, addressed to the operator at the address above, on October 23 , <br />19 86. <br />Certified Mail No. P 168 480 183 <br />Return Receipt R que ted <br />Signature of erson Served Sig ure <br />if personal service <br />Michael S. Savage, Assessment Officer <br />Print Name and Title 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 />By <br />Signature <br />Date 19 <br />(5/85) <br />Doc. No. 251 <br />