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2012-05-11_REVISION - C1981038
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2012-05-11_REVISION - C1981038
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Entry Properties
Last modified
8/24/2016 4:57:33 PM
Creation date
5/14/2012 9:35:23 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981038
IBM Index Class Name
REVISION
Doc Date
5/11/2012
Doc Name
Certified Return Receipt (Inspection Notification)
From
Dennis Lukens and Sharon R Lukens
To
DRMS
Type & Sequence
SL4
Email Name
BFB
SB1
Media Type
D
Archive
No
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c__Alov(1\ -C3) <br />`1iaiiesttLon <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Dennis Lukens and Sharon R. Lukens <br />P.O. Box 115 <br />Paonia, CO 81428 <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />ervice Type <br />] Certified Mail <br />❑ Registered <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) <br />7008 3230 0002 7252 9385 <br />Domestic Return Receipt <br />MAY 1'2012 <br />DivosIu reclamation, <br />Mining and Safety <br />SEN COMPLETE THIS SECTION <br />COMPLETE THIS SECTION ON DELIVERY <br />Ir <br />7 <br />a <br />B. Rece' _ • by l 'nted Nam?) <br />r L a � <br />A. Signature a <br />gent <br />❑ Addressee <br />to <br />Deli <br />ry <br />D. Is delive address different from Item 1? ❑ Yes <br />If YES, enter delivery address below: 'R <br />❑ Express Mail <br />❑ Return Receipt for Merchandise <br />❑ Yes <br />102595 -02 -M -1540 <br />
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