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RECEIVE <br />DEC 272011 <br />L71vl5wn <br />Mining and <br />0 <br />9 <br />a) <br />7 <br />at <br />L <br />c <br />0 <br />-o <br />Y <br />d <br />0. <br />E <br />0 <br />rn <br />m <br />w <br />CC <br />c <br />4 <br />CC <br />z <br />1- <br />W <br />CC <br />0 <br />0) <br />UNITED STATES POSTAL SERVICE <br />T.K Construction <br />LLC dba T K Mining Services, LLC <br />P. 0 Box 93 <br />Delta, CO ,81416 <br />5. Received By: (Print Na 4), <br />1 V C_ \ l al ►L 41 rl - <br />6. Signatur • (Addressee or Agent) <br />� <br />X <br />PS Form 3811, December 1994 <br />ii <br />• Print your name, address, and ZIP Code in this box • <br />State of Colorado <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safety <br />1313 Sherman Street, Room 215 <br />Denver, CO 80203 <br />SENDER: <br />• Complete items 1 and/or 2 for additional services. <br />• Complete items 3, 4a, and 4b. <br />• Print your name and address on the reverse of this form so that we can retum this <br />card to you. <br />• Attach this form to the front of the mailpiece, or on the back if space does not <br />permit. <br />• Wnte'Return Receipt Requested' on the mailpiece below the article number. <br />• The Retum Receipt will show to whom the article was delivered and the date <br />delivered. <br />3. Article Addressed to: 7008 114 0 <br />dih /ahh <br />C1981 d <br />CV- 201 -008 <br />Notice of Violation <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />Consult postmaster for fee. <br />0003 4437 5586 <br />). Service Type <br />] Registered ❑ Certified <br />] Express Mail ❑ Insured <br />] Retum Receipt for Merchandise ❑ COD <br />. Date of Delivery <br />1 = 2Z - 'l <br />8. Addressee's Address (Only if requested <br />and fee is paid) <br />Domestic Return Receipt <br />First -Class Mail <br />Postage & Fees Paid <br />LISPS <br />Permit No. G -10 <br />