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m <br />a <br />E <br />0 <br />V <br />N <br />to <br />w <br />cc <br />4 <br />cc <br />z <br />5. Re eived By: (Print Name) <br />J o r e A YVL.2' r 'L <br />cc <br />•3 6. Signal r . (Addressee or Agent) <br />T • X3G(L« 5" <br />— co PS Form 3811, December 1994 <br />Arent Peterson <br />*fit_ Energy, LLC <br />11783 Highway 337 <br />Tijeras, NM 87059 <br />di 'JITED STATES POSTAL SERVICE <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, Suite 215 <br />Denver, CO 80203 <br />• SENDER: <br />•Complete items 1 and/or 2 for additional services. <br />m <br />•Complete items 3, 4a, and 4b. <br />H ■ Pnnt your name and address on the reverse of this form so that we can return this <br />It 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'Retum Receipt Requested' on the mailpiece below the article number. <br />. •The Return Receipt will show to whom the article was delivered and the date <br />c delivered. <br />0 <br />o 3. Article Addressed to: <br />I also wish to receive the <br />following services (for an <br />extra fee): ai <br />1. ❑ Addressee's Address ' v <br />2. ❑ Restricted Delivery rn <br />Consult postmaster for fee. d <br />7008 3230 0002 7252 9422 c <br />4b. Service Type E a <br />❑ Registered ❑ Certified cc <br />❑ Express Mail ❑ Insured w <br />❑ Return Receipt for Merchandise ❑ COD 7 <br />7. Date of Delivery <br />c 5 /A A e t- <br />8. Addressee's Address (Only if requested <br />and fee is paid) <br />01981 -035 <br />CV -2012 -003 Amount <br />Notice of Propo Am <br />of C ivil Penalty <br />pIH <br />Domestic Return Receipt <br />i- <br />First -Class Mail <br />Postage & Fees Paid <br />LISPS <br />Permit No. G -10 <br />