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SENDER: COMPLETE THIS SECTION <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 />Theresa Frlederich- Takasugi <br />4571 New Hampshire Street <br />San Diego, CA 92116 <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />� I ! UNITED STATES Po i$41TI tt.t`sidll,iii,E ii1 ` <br />• Sender: Please print your name, address, and ZIP +4 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 />Domestic Retum Receipt <br />COMPLETE THIS SECTION ON DELIVERY <br />A. Signature <br />X <br />f <br />❑ Agent <br />❑ Addressee <br />ate of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />❑ Certified Mail ❑ Express Mail <br />❑ Registered ❑ Retum Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) <br />7010 1060 0001 0936 2912 <br />Itirst -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />C1g82 - 051 <br />St--'Bond Release Inspection <br />B° a tion <br />Notifica <br />LEI A <br />❑ Yes <br />102595 -02 -M -1540, <br />