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2015-08-21_REVISION - C1981008
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2015-08-21_REVISION - C1981008
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Entry Properties
Last modified
8/24/2016 6:10:07 PM
Creation date
8/24/2015 10:13:26 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981008
IBM Index Class Name
Revision
Doc Date
8/21/2015
Doc Name
Certified Return Receipt (Inspection Notification)
From
Benson Bud and Teresa Family Living Trust
To
DRMS
Type & Sequence
SL15
Email Name
BFB
DIH
Media Type
D
Archive
No
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V"Mfii <br />UNITED STATE ERVICE <br />Sender: <br />First -Class Mail <br />Postage & Fees Paid <br />4 <br />USP <br />No. G-10 <br />04- <br />PH 304- <br />Sender: Please print your name, address, and ZIP+4� in thi� • <br />State of Colorado 0+1FeGSa� <br />Department of Natural Resources <br />Division of Reclamation, Mining & Safety O0y�`�\� <br />1313 Sherman Street, Suite 215 <br />Denver, CO 80203 $ <br />0 <br />G,198�.0 tion <br />S\',15 t. ,c► clot`{%Ca <br />l�sPec <br />� #►={tril�f�4�tlN� �it��r <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 />A. Signature <br />El Agent <br />B. Received yy (PdOgd Name) I C. Date of Delivery <br />Yes <br />Is delivery address different from item 1? No <br />If YES, enter delivery address below: <br />Bud Benson <br />Benson, Bud and Teresa Family Living Trust <br />16201 E Yucca Ash Farm Rd pe <br />AZ 85637-6702 _..._d Mail® 13 Priority Mail Express" <br />$OnOlta, I ❑ Registered ❑ Return Receipt for Merchandise <br />0 Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number ?014 0150 0000 913 8 9523 <br />(Transfer from service label) <br />PS Form 3811, July 2013 Domestic Return Receipt <br />
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