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DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-029 <br />C.0. NO.: N/A <br />N.O.V. NO.: C-94-011 <br />I hereby certify that I served a copy of the foregoing NOTICE OE PROPOSED AMOUNT <br />OF CI'JIL PENALTY on the operator therein described by depositing a true copy <br />thereof first class postage prepaid in the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on June 21, 1994. <br />iii iiiiiiiiniiiiii <br />999 <br />h <br />n~„ <br />~ ~ .,c; ~,~r. <br />UN ~ <br />~~~~. <br />-•a... <br />~.. , <br />"r <br />Certified Mail No.: P 296 602 755 <br />Return Receipt Requested„ <br />Signature of Person Served <br />if personal service <br />9 <br />David A. Berry, Assessment Officer <br />Print Name and Title Print Name and Title <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 />o~7lLlli ~~ <br />Operator <br />~ (Signature) <br />Date / -Q7 19~. <br />DAB/bjw <br />0586E <br />