_ENFORCEMENT - C1981017 ‎(19)‎

• Permit No: C1981017
• IBM Index Class Name: Enforcement
• Doc Name: Bid Documents ‎(IMP)‎ CV-91-015
• Violation No.: C-91-015
• Media Type: D
• Archive: No

MINED LAND RECLAMATION DIVISION
CERTIFICATE OF SERVICE
PERMIT NO. : C-81-017
C.O. NO. :
N.O.V. NO. : C-91-015
I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT
OF CIVIL PENALTY on the operator therein described by depositing a true copy
thereof first class postage prepaid in the United States mails at Denver,
Colorado, addressed to the operator at the address above, on October 7, 1991 .
Certified Mail No. : P 075 312 721
Return Receipt Requested
Signature of Person Served � (Signature)
if personal service
L ar�fl eW. Self N��lat rc e�
Print Name and Title Print Name and Titre
---- Check applicable method of service.
REQUEST FOR CONFERENCE
The operator above described hereby requests an assessment or settlement
conference as permitted by C.R.S. 34-33-123(8) .
Operator
By
(Signature)
Date 19
LPR/eke
8676E