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<br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT N0. C-002-80 <br />C.O. N0. <br /> <br />APR 2 ~ 1986 <br />MINED LAND RECLARtATION <br />Colo. Dept, o(Na!era! Resources <br />N.O.V. N0. C-86-024 <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 XX 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 abcve, on April 14 , <br />19~. <br />ignature o erson erve <br />if personal service <br />Print Name and Title <br />Certified Mail No. P 169 876 268 <br />Return Receipt Requested <br />ignature <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 />By <br />Signature <br />Date <br />(5/85) <br />19 <br />Doc. No. 251 <br />