Laserfiche WebLink
<br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT N0. None <br />C.0. N0. C-86-046 <br />N.O.V. N0. <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 or XX <br />copy thereof first c ass postage prepaid in the United <br />Colorado, addressed to the operator at the address abo~ <br />1986 . <br />NOTICE OF PROPOSED AMOUNT <br />_(a)* personal service <br />,b * by depositing a true <br />States mails at Denver, <br />re, on June 26 , <br />Certified Mail No. P 169 876 378 <br />Return Receipt Req sted <br />ignature o erson erved ignature <br />if personal service <br />ffi r <br />Print Name and Title Print Name and itle <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 />ure <br />Date <br />(5/85) <br />19 <br />DOC. No. 251 <br />