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L.G. Everist, Inc. <br />Fort Lupton Sand and Gravel Mine <br />M.L.R.B. Permit # M- 1997 -120 <br />Adequacy Response lb Proof of Mailing to Weld County Clerk <br />U.S. Postal Service <br />CERTIFIED MAIL RECEIPT <br />(Domestic Mail Only; No Insurance Coverage Provided) <br />For delivery information visit our website at www.usps.com, <br />Retum Receipt Fee <br />(Endorsement Required) <br />Restncted Delivery Fee <br />(Endorsement Required) <br />Total Postage & Fees <br />Sent To <br />Street, Apt. No , <br />or PO Box No. <br />City. State. ZIP+4 <br />Postage <br />Certified Fee <br />SENDER: COMPLETE THIS SECTION <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desked. <br />• Print your name and address on the reverse <br />so that we can n3tum the card to you. <br />■ Attach this card to the back of the maiipiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Weld County Clerk to the Board <br />Board of County Commissioners <br />Office <br />1150 0 Street <br />Greeley, Colorado 80631 <br />2. Article Number <br />(Transfer from =nice kW <br />PS Form 3811, February 2004 Domestic Return Receipt <br />Usps <br />10/10/2012 <br />Weld County Clerk to the Board <br />Board of County Commissioners <br />Office <br />1150 0 Street <br />Greeley, Colorado 80631 <br />co <br />COMPLETE THIS SECTION ON DELIVERY <br />. Received by (Printed Name) <br />C. Date of Delivery <br />add t from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />P Type <br />e: Man <br />❑ Registered <br />❑ Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />7010 2780 0002 1654 0122 <br />❑ Express Mail <br />❑ Return Receipt for Merchandise <br />❑ C.O.D. <br />❑ Yes <br />102595-024A-1540 <br />