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UNITED STATES POSTAL SERVICE
<br />First-Class Mail
<br />Postage & Fees Paid
<br />USPS
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<br />• Sender: Please print your name, address, and Zlf~ ~ • ~,~;
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<br />STATE OF i;ciLUriA00 O ' /~~~ ~
<br />DEPARTMENT OF NATURAL RESOURCES ~ ~~
<br />DIVISION OF RECLAMATION MINING ANO SA~E1Y pivision or rteclamago
<br />1313 SHERMAN STREET, SUITE 215 Mining_and Safety
<br />DENVER, COLORADO 80203
<br />..341300000 ~ Cs
<br />spec. ,,._.~,.M
<br />- Ftte # N~S~'©~3
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<br />^ Complete items 1, 2, and 3. Also complete
<br />item 4 if Restricted Delivery. is desire ~~
<br />^ Print your name and address on t r~ller~6},~
<br />so that we can return the card tp, r~C` " ~^
<br />^ Attach this card to the back of hey ailpi~er~
<br />or on the front if space permit ~'~ "'
<br />1. Article Add ed to: ~ ` °t/f/®
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<br />A. Signature /
<br />X~~~` Agent
<br />~ Addressee
<br />B. Received by (Printed Name) ~ C. Date of Delivery
<br />Is delivery address different from item 11 ^ Yes
<br />If YES, enter delivery address below: ^ No
<br />/~ ~Y! / ~!7 J~ t ~ , 3. Service Type .
<br />L ^ CeRified Mail ^ F~cpress Mail
<br />^ Registered ^ Retum Receipt for Merchandise
<br />(~/ ~~ ~ ^ Insured Mail ^ C.O.D.
<br />4. ResVicted Delivery? (Extra Fee) ^ Yes
<br />2. Article Number
<br />(~rans~erfromservlcefaben 703 1680 ~DO~ 6422 8085
<br />PS Form 3811, February 2004 Domestic Return Receipt 102595.02-M-1540
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