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WB C <br /> MINED LAND RECLAMATION DIVISION <br /> CERTIFICATE OF SERVICE <br /> PERMIT NO. C-81-017 <br /> C.O. NO. <br /> N.O.V. N0. C-89-032 <br /> I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT <br /> OF CIVIL PENALTY on the operator therein described by (a)* personal service <br /> upon the operator or its representative at , <br /> Colorado on 19 or -4X__ b * by depositing a true <br /> copy thereof first class postage prepaid in the United States mails at Denver, <br /> Colorado, addressed to the operator at the address above, on Dpramhar 21 <br /> 19-aL. <br /> Certified Mail No. P 767 447 543 <br /> Return Rece t equested <br /> �� n <br /> Signature of Person Served (S ignat re <br /> if personal service <br /> Michael S. Savage, Assessment Officer <br /> Print Name and Title Print Name and Title <br /> * ---- Check applicable method of service. <br /> REQUEST FOR CONFERENCE <br /> The operator above described hereby requests an assessment or settlement <br /> conference as permitted by C.R.S. 34-33-123(8). <br /> Operator <br /> By <br /> S!gnat e <br /> Date Z/t�r_ 19� <br /> (5/85) <br /> Doc. No. 251 <br />