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2009-06-16_REVISION - C1980005 (2)
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2009-06-16_REVISION - C1980005 (2)
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Entry Properties
Last modified
8/24/2016 3:47:51 PM
Creation date
6/18/2009 1:51:24 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1980005
IBM Index Class Name
REVISION
Doc Date
6/16/2009
Doc Name
Certified Returned Receipt Card (Inspection Notification)
From
Land Board of Commissioners
To
DRMS
Type & Sequence
SL4
Email Name
DTM
Media Type
D
Archive
No
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SL ?{ <br />¦ Complete items 1, 2, and 3. Also complete A. Signature <br />item 4 if Restricted Delivery is desired. ? Agent <br />¦ Print your name and address on the reverse ? Addressee <br />so that we can return the card to you. <br />¦ Attach this card to the back of the mailpiece , R ceived b (Printed Name) C. Date of Delivery <br />, <br />• or on the front if space permits. / `Cr <9 <br /> <br />1. Article Addressed to: D. Is delivery address different from item 1? ? Yes <br /> If YES, enter delivery address below: ? No <br /> <br />j State of Colorado-Board of Land Commissioners <br />Department of Natural Resources <br />1127 Sherman Street, Suite 300 <br />Denver, CO 80203 Type <br />2. Article Number <br />(Transfer from service label) <br />Med Mail ? Express Mail <br />stered ? Return Receipt for Merchandise <br />U Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />7006 3450 0000 4880 2296 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
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