Laserfiche WebLink
M~ <br />'( UNITED STATES POS <br />~~~.. <br />~~ parr ? pry ~ <br />• Sender: Please print your name, address, and ZIP+4.in this box <br />STATE OF COLORADO <br />DEPARTMENT OF NATURAL RESOURCES <br />DIVISION OF RECLAMATION, MINING /AND SAFETY <br />t313 SHERMAN STREET, SUITE 215 <br />DENVER, COLORADO 80203 <br />3d730D000 <br />File # ~'1'.~1~~'227-i'~~i <br />,. <br />,I !i. ~ li~i ill,li;!;i, ii ~~;1; I , <br />11„111,~,,,I,IIG,~„1-,„i,l„I,-,-„L,l1„11,„-,I„I,1,1 <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />t. Article Addressed to <br />Mr William E Burnett <br />5002 Syndt Rd <br />Evergreen CO 80439 <br />~_ 1~~,~- aaa>aG <br />~~ - Ode <br />5- 023 -D~ <br />n _ e,e~ <br />~~~}. <br />X s~sna~ <br />~ Agent <br />ddressee <br />e. Received by (Footed Name) C. Date of Delivery <br />~f•(_ . <br />D. Is delivery add differem from itemY4~'` Yes <br />If YES, enter d liveryaddress below: '~^`.No <br />X21 <br />200J ~ r•, ~ <br />3. Service Type "Sr ,Fi-. <br />3 <br />^ Certifed Mail ^ R <br />^ Registered ^ Retum Receipt id ~QA815bandise <br />^ Insured Mail ^ C.O.D, ~'Q <br />4. Restricted Delivery4 (Extra Fee) ^ yes <br /> <br />2. Article Number <br />(Fiansfer from service lab~rrlrl ,„r , 0 D 6 $92 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1549 <br />