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UNIT . L SERVICE First-Class Mail <br /> Postage&Fees Paid <br /> USPS <br /> O 201" 1 it No.G-10 <br /> • SeonfW, , rint your name, address, a I in t 's ox* <br /> M 1101609&SafetY 7 c0�^ <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 Spt: C-1980-007 <br /> File SL-10 <br /> Proposed Dec <br /> !!!!i!'!!'I!!i'!'l!!!j!!lilF;illll'i'liiili I" jih";"!' <br /> COMPLETE <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. X l) ElAgent <br /> ■ Print your name and address on the reverse / (� a� l ❑Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> 1. Article Addressed to: D. Is delivery address different from item 1. ❑ es <br /> If YES,enter delivery address below. IQ o <br /> Delta County Commissioners : Q, <br /> County Commissioner <br /> 501 Palmer Street, #227 <br /> 3. Service Type <br /> Delta, CO 81416 ❑Certified Mail® ❑Prioritg Wl Express- <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (Transfer from service label) 7 014 0150 0000 91,38 5181 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />