Laserfiche WebLink
• ~ • ~ ~~~IIIIIIIIIIIIIIIIIII <br />RECEIVED <br />L)I~i' ':; 1':;a~t0 <br />)EC 291980 r,~iNED LAnJo Hcc) nra~,ru.~ <br />aT1`1~9I,_~F_Sspv_14; Co!o.Dept.o(~~aturai,iesu_~•_. <br />.ND p.ECLAM,AT(pN-COAL <br />~ O~~JAT tkCSESUkC~y Cer t~fy that S?f ved d CODy Of the fOr2C]Oin^y <br />.~ilLt JF P?~PJScJ oNCJ'JT JF CIVII PE'JaLTY on the operator <br />tncrzin Jescrio~u by ______(a);° personal service upon the <br />ooeracor or its raGresentativ: zt <br />-------------------------. LolCrado on <br />--------------- <br />19___. or __v__(b)~ py c-?osit~.n., s true copy thereof first <br />class Nostay~ pr2~aid in the UnitE^ States Tails at Denver, <br />COIOf d:.O. adUres~d *_O 'h< Opcr~tOf oL the d~jdre55 abOVe. On <br />0 <br />~/ ~ <br />/-/~C ``.t,.'~-lam ,~~i j' `C'~:~.' Jai <br />Signature <br />/ I ~'~ <br />------------------------------------------ <br />`:a;ne ?tinted <br />• -- Cnack applicable one Lhod of service. <br /> <br />Tne oGtrator above described hereby requests an assess- <br />a.ent or settlement conference as pe nnitted by C.R.S. 34-33-123(9). <br />--- JYtgl~LrllAS~--~f9R~_ ~A_--------- <br />^perator <br />(Signa ure) <br />J a t e --,~~--`~`~ ------' 19 f3'~7 <br />~l~ V 8v -4z <br />CYR/L'.iOJJS/1CE <br />