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iii ~iii~iiiuiiiiii <br />999 <br />RECEIVED <br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT N0. C-81-022 <br />C.0. N0. <br />N.O.V. N0. C-87-012 <br />I hereby certify that I served a copy of the foregoing <br />OF CIVIL PENALTY on the operator therein described by _ <br />upon the operator or its representative at <br />Colorado on 19 ,`o~(X1~ <br />copy thereo first c ass pos age prepaid in the United <br />Colorado, addressed to the operator at the address abo <br />Signature of erson Served <br />if personal service <br />rent ame an i e <br />JUN 2$1987 <br />MINED LAND <br />RECLAMATION 0I'JI510N <br />NOTICE OF PROPOSED AMOUNT <br />(a)* personal service <br />y epositing a true <br />States mails at Denver, <br />re, on June 12, 1987. <br />Certified Mail No. P 168 480 046 <br />Return ~et equested <br />gnatur <br />Michael S. Savage, Assessment Officer <br />Print Name and Title <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by C.R.S. 34-33-123(8). <br />K~ 1s~~Z C off- C~ ~Po~n~r.~ <br />0 e or <br />- By _ <br />gatre <br />Date ~ ~`~~ 19~~~ <br />0445E <br />