2016-11-30_GENERAL DOCUMENTS - M2012014

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UNITED STATES POSTAL SERVICE � � !stg� iS Paid U.S. Postal Service'" CERTIFIED MAILP RECEIPT �- Domestic Mail Only ' Sender: Please print your name, address, and ZIP+41 in this box' ru Ln $0 675 State of Colorado �e r Department of Natural Resources ,.,postage*. �,: m• 1 o Certified Fee: " ,700 tmark Division of Reclamation,Mining&Safety o Return Receipt Fee: Y J�t ere Jt1ci:exa/6� n AQ��b,75 1313 Sherman Street,Room 215 o ru and Fees, Denver,CO 80203 M-2012-014 � Total Postage 30-day Grace letter ru -_... Ldge z�Fees $ PSH WHE AJW = Sent To y1 r_1 John DietAer r_3 Street&Apt-No;--• Dietzler Construction Corporation :€`s=:•}t••i :_.;:}•I•�:.,...; ._ .;'`• ... or PO Box No. 5027CR37 _____ ' " '• •' • --------------------- Cdy,State,ZlP+4 Yoder,WY 82244 PS Form 38.00,July 1 -1__1L_t_II Reverse Certified Mail:---�___..__: owing benefits: in A Certified Mail recei M-2012-014 P �•include applicable postage to Certified Mail label). 30—day Grace letter;'return receipt service fee;and ■A unique identifier for PSH WHE AJW he mailpiece"Return Receipt o Electronic verification, _.___ r _ -----d,"or see a retail associate for delivery. assistance.For an electronic return receipt, ■A record of delivery(including the recipient's see a retail associate for assistance.To r signature)that is retained by the Postal receive a duplicate return receipt,present Servicea for a specified period. this USPS�-postmarked Certified Mall receipt to the retail associate,who will COMPLETE SECTION • • • • Important Reminders: provide a duplicate return receipt for no ■You may purchase Certified Mail service with additional fee. First-Class Mail',First-Class Package -Restricted delivery service,which provides ■ Complete items 1,2,and 3.Also complete A. Signature rY P p p Agent :Service',or Priority Mail"service. delivery to the addressee specified byname, item 4 if Restricted Delivery is desired. X / [ // Certified Mail service is not available for or to the addressee's authorized agent. ■ Print your name and address on the reverse l�f� Z(r[ ❑Addressee international mail. Include applicable postage to cover the so that we can return the card to you. ■Insurance coverage is notavailable for restricted delivery fee and endorse the Y B Recei d by ted Name) C. Date of Delivery purchase with Certified Mail service.However, mailpiece"Restricted Delivery,'or see a ■ Attach this card to the back of the mailplece, r }L l( J / the purchase of Certified Mail service does not retail associate for assistance. /twor on the front If Space permits. I change the insurance coverage automatically ■To ensure that your Certified Mail receipt is D. Is delivery address different from item 1? [1,,Yes included with certain Priority Mail items. accepted as legal proof of mailing,it should 1. Article Addressed to: If YES,enter delivery address below: 1,a No ■For an additional fee,you may request the bear a USPS postmark.If you would like a following services: postmark on this Certified Mail receipt,please Return receipt service,which provides you present your Certified Mail item at a Post — with a record of deliver mcludin the Office for postmark'n .If you don't need a John Dietzler p ��gjpjur� � a�eg9 atl tm�?Jjyllii�Q�tI � detach Dietzler Construction Co nardcopY return receipt or n electronic -thebarcoded por$o�i Oil to affix ft to the rporatlon version.For arlc3yS I IpLd n S ;adpiiltt!>tonwrorili5ostage,and 5027 CR 37 complete r ne�$s�i -a�, l iece. Yoder,Wy 82244 Receipt attach PS Form �y, r r CM�POKTAH1Kbtai is receipt for your records. 3. Service Type Ps Form 3800,July 2014(Reverse)PSN 7530-02-000-9047 ❑Certified Mail® 0 Priority Mail Express- 0 Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ Collect on Delivery 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7014 2120 0001 7885 2646 (Transfer from service labeq PS Form 3811,July 2013 Domestic Return Receipt