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MINED LAND RECLAMATIGN DIVISION N° 011330 <br />1313 Sherman, Room 215 ~~g <br />Denver, Colorado 80203 DATE ? ~ Z ~ 1 g_{~L_ <br />(303) 866-3567 <br />o~ ~° F~1,~ I~I ~,.,D„ $ so. v <br />- ~// ''II ^ CASH <br />FORf~~FO ~ ' 7S~ " ~ ~ ~l S~ 7 ~.CHO K <br />AMOUNT OF COU~$ ufAV~l <br />AMOUNT PAID ...................$ Q ~ OU~ <br />BALANCE OUE ............. .....$ BY <br /> <br />• °9YDER: Complete items 1 and 2 when additional services era desired, and complete items <br /> nd 4. <br />Pu~ur address in the "RETURN TO" Space on the reverse side. Failure to do this will prevent this <br />car d from being returned to ou. The return recei t tee will rovrde ou the name o} the arson delivered <br />to end the data of deliver .Fora itiona ees t e o owing services are ever a e. onsu t postmaster <br />or ees en c ac c ox es for additional servicelsl requestetl. <br />1. ^ Show to whom tleliverad, tlate, end addressee's address. 2. ^ Restrictetl Delivery <br /> (Palm cMrgel (Extra cMrge) <br />3. Article Addressed to: 4. Article Number <br /> <br /> <br /> <br /> Type of Service: <br /> c <br />~' ~' ~OK' . ~/ o ~ ^ Repiatered ^ Insuretl <br />~Gertilied ^ COD <br /> ^~Q <br />~~ (~ / / <br />, <br />_ ^ Express Meil ^ Return Receipt <br />for Merchandise <br /> ~ <br />~ <br />IQ~ <br /> Alweya obtain cigneture of etltlreaaee <br /> or agent and DATE DELIVERED. <br />5. azure - dress R. Addressee's Address (ONLYif <br />X requested and fee paid) <br />6. ignature -Agent <br />X <br />7. Date of Delivery <br /> <br />PS Form 3$17, Mar. 1988 • U. S.6.P.0. ig88-212-885 DOMESTIC RETURN RECEIPT <br />