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STATE OF COLORADO , <br /> Division of Minerals and Geology F�";kfall <br /> 0GoMfta� nDepartment of Natural Resources �.- �'�1313 Sherman Street, Room 215 Mail � M I - <br /> Denver,Colorado 80203-2273 � `? 1 crenefty of ) 9700 <br /> 198 iq'9 <br /> .. i J, orfMato Use rLO• <br /> i 1300000 . q�r 1 6 I _ 0 <br /> L � <br /> _ M JOSEPH DODGE _ �tr,rt''• Pn '114 <br /> r r OEM C NN MOUNTAIN MINING INC :nsolli es, <br /> mllit of The return acldres� 1226 ELM AVENUE (� _ !f1Cfg---, <br /> CANON CITY CO 8I2I2CERTIFIED Waj' <br /> Z 416 876 933 :4. <br /> � Inih�is ?1. Flo. <br /> •Complete items 1 and/or 2 for additional services. )also-wish to receive the <br /> e .CM WDUems a,ea,and ib. following services(for an <br /> •` •Print your name and address on the reverse of this form so that we can return this`»fe extra fee): <br /> cam to you. o <br /> *Attach this form to the horn of the meikece,or on the back if space does rro1 1. ❑ Addressee's Address <br /> w eWhle'Refum Receipt Requested'on the mailpisce below the article number. 2. ❑ Restricted Delivery y <br /> a The Return Recepi will show to whom the article was delivered and the dale <br /> u delivered. Consult postmaster for fee. E. <br /> 3.Article Addressed to: 4a.Article Number e <br /> I Ito q� e I <br /> MR JOSEPH DOD0E 4b.Service Type o <br /> _-_ PSNN MOUNTAIN MINIX INC 17 Registered $(Cenifted o <br /> 1228 EID AIBNI <br /> » - - <br /> CANON CITY CO 81212 ELReturn Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery $ <br /> 0 <br /> 5.Received By: (Print Name) 6.Addressee's Address(Only if requested <br /> and fee is paid) c <br /> r <br /> 6.Signature: (Addressee or Agent) <br /> i X <br /> w <br /> PS Form 3811, December 1994 Domestic Return Receipt <br />