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A. Si ature " "w <br /> ■ Complete items 1,2,and 3.Also complete • '""�"` .�"" `"""�.., <br /> item 4 if Restricted Deliverys td ens <br /> ■ Print your name and address on the reverse dresse <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Deliven <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> (z" <br /> CC)I? � <br /> 3. ervice Type <br /> Certified Mail® ❑Priority Mail Express— <br /> Registered ❑Return Receipt for Merchandisf <br /> ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑ Yes <br /> 2. Article Number 7 014 2120 0001 <br /> (Transfer from service labeq lii,',11gfif1m,+1f,llip, j,Trrlra T�71Tf <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> i <br /> UNITED STA SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> LISPS <br /> Permit No.G-10 <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 Spe­Ft'C--� <br /> File _QiLQ--Q(QS <br />