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<br />DIVISION OF MINERALS AND GEOLOGY RECE~~ED <br />JUL 2 ~ 1995 <br />CERTIFICATE OF SERVICE <br />Permit No. C-82-055 Division of Minerals & Geology <br />NOV No. C-95-018 <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT OF CIV[L <br />PENALTY on the operator therein described by depositing a true copy thereof, first class postage <br />prepaid, in the United States mails at Denver, Colorado, addressed to [he operator at the address above, <br />on July ] 0, 1995. <br />Signature of Person Served ~/~9/~~ <br />if Personal Service <br />~i~e~s -~~~~~ <br />Name and Title ~ <br />Certified Mail No. P 296 607 648 <br />Return Receipt Requested <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement conference as permitted by <br />C.R.S. 34-33-123(8). <br />Operator lJ <br />By s 0~~~-~~~ <br />(Sig afore) <br />Date ?/1`~ 1995 <br />~rvMROrM.rr <br />uav~o w. tsem. wssessment utricer <br />(Print Name and Title) <br />