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UNITED STATES POSTAL SERVICE <br />First-Class Mail <br />Postage & Fees <br />LISPS <br />Permit Pio. G-10 <br />• Sender: Please print your name, address, and Zi1P+4~i <br />.,, <br />STATE OF COLORADO <br />DEPARTMENT OF NATURAL RESOURCES <br />DIVISION OF RECLAMATION MINING AND SAFETY <br />1313 SHERMAN STREET, SUITE 215 <br />DENVER, COLORADO 80203 <br />341300000 <br />.~ <br />lox • <br />u, '' <br />r~s~,~ <br />Spec. . <br />FIIe ~ ~-..~9-Ipl± <br />I,1,~~~II~,,~,~;~fl,rr~.ii,.,i,~i~~t~t,t,,l„~~.ttrr,l~~.~t,i.i <br />~~C 2 <br /> <br />~~~-- ll~'-r ~ J~.~~~~~-~ <br /> <br />i ~ ~"~~~~ <br />A. Signature + ^ Agent <br />^ Complete items 1, 2, apd 3. Also complete <br />item 4 if Restricted Delivery is desired. ~( ~' ~ ~ r `;~ ~' ~ ^ Addressee <br />^ Print your name and address on the reverse ~. ,pate of Deli <br />so that we can return the card to you. / ce~e (~Printe~,l~~ ~~~ 1 _, jG~ <br />^ Attach this card to the back of the mailpiece, S/ <br />or on the front if space permits. D.,Is delivery address different from item 1? ~ Yes <br />If YES enter delivery address below: ^ No <br />1f/~///)Article Addres~s//QJd to: / ~, <br />i ~3,~---''; . <br />/ ~j ~ ~ ~ ~~ 3. Service Type <br />^ Certified Mail ^ Express Mail <br />~~~'f/` L~ r rl ^ Registered ^ Return Receipt for Merchandise <br />!!ll~~~~ q ~) U ~ .L._ ^ Insured Mail ^ C.O.D. <br />/ / 4. Restricted Delivery? (Extra Fee) ^ Yes <br />2. Article Number 7 0 0 5 317, D D D 0 0 219 9 3 0 0 9 <br />(Transfer from service label) 102595-02-M-1540 <br />Domestic Return Receipt <br />PS Form 3811, February 2004 _ _ <br />