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1 LI° A75 iA W OST1.�0 ,s 4 c <br />UNITED <br />QM77 d <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 />• 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 />Lisa Escher — Ranch Manager <br />Lazy H Ranch <br />44964 Highway 133 <br />Paonia, CO 81428 <br />C1980 -007 - <br />SL-5 <br />Inspection Notification Letter <br />-1 -7 <br />A. Signature <br />_ Agent <br />X Addre <br />B. Received by( P 'nted Name) C. Date of Delivery <br />D. Is delivery address different from Rem 1? ❑ Yes <br />If YES, enter delivery address below: (Y No <br />3. Service Type <br />❑ Certified Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mall ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7010 1060 0001 0936 3056 <br />(Transfer from service iabei) <br />PS Form 3811, February 2004 <br />Domestic Return Receipt 102595-02 -M -1540 <br />