REP43427

• Permit No: M1986010
• IBM Index Class Name: Report
• Doc Date: 1/20/1995
• Doc Name: NOTICE OF INTENT TO CONTINUE MINING OPERATIONS 110 2 ANNUAL REPORT
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

P 296 797 221
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FREMONT COUNTY BOARD OF COMI
615 MACON AVE ROOM B-5
CANON CITY CO 6121r
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Povmad or Dale
SENDER:
• Complete items 1 and/or 2 for adtlitionel services. I also wish to receive the
• Complete iteme 3. and 4a & b. following services (tor an extra
• Print Vour name and address on the reverse of this loan so that we tan feel:
return this card to you.
• Attach this form to the tronl of the meilpiece, or om the back it space
1. ^ Addressee's Address
does net permit.
• Write"Return Receiptflequestetl"on the mailpiece below the article numb¢i. 2. ~ ReatriCted Delivery
• The Return Receipt will show to whom the article was delivered and the tlate
delivered.
Consult postmaster for tee.
3. Article Addressed to: a. Article Number
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4EMONT COUNTY BOARD OF COMM 4b. Service Type
^ Registered ^ Insured
15 MACON AVE ROOM B-5 C~ Certified ^ COD
ANON CITY CO 61212 ^ Express Mail ~eturn Receipt for
Merchandise

- 7. Date o elivery
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5. Sig
tu (Adgresseel 8. Addressee's Address (Only it requested
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I 1 and fee is paid)
6. Signature (Agent)
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> PS Form 3811, December 1991 OU.a.GPO:t ~]t4 DOMESTIC RETURN RECEIPT
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