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<br />UNITE) STATES POSTAL SERVICE First-Class Mail <br />' Postage & Fees Paid <br />USPS <br />Permit No. G-10 <br />• Sender: Please print your name, address, and ZIP+4in this <br />Vt,ECgR l <br />STATE OF COLORADO A 0 - 7 2009 <br />DEPARTMENT OF NATURAL RESOURCE=S <br />DIVISION OF RECLAMATION, MINING & SAFETY p( ilan.or t4eclW <br />1313 SHERMAN STREET, SUITE 215 Miring and Sat, <br />DENVER, COLORADO 80203 <br />QSI? <br />341300000 Spec.' <br />I # ry.lg_ ass <br />1494 ?r tL <br />¦ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />¦ Print your name and address on the reverse <br />so that we can return the card to you. <br />¦ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />Article Addressed to: <br />?ih L?r4R li ? G?F? i , ?/G <br />64%Ae f RM?Grf c.?it`1 <br />5-? aOo <br />W ff 77" r-P5 ? M- r Ld J`,00671 <br />A. Signature <br />? Agent <br />X <br />? Addre <br />B. Received by (Printed N C. We o?Dpli <br />D. Is delivery address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />3. Service Type <br />? Certified Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise . <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article aumber 7006 3450 0000 4880 8540 <br />(transfernsfer from service label) <br />PS <br />Postal (Domestic C3 CERTIFIED MAILT. RECEIPT <br />Mail Only, No Insurance Coverage Provided) <br />Lrl For delivery information visit our website at www.usps.come <br />C3 <br />CID <br />Postage: °;? ° $1.05 <br />E3 Certified Fee: $2.80 <br />C3 R? <br />C3 (Endow= Return Receipt Fee: $2.30 <br />Restrii <br />(Endors Total Postage & Fees: y ?$6. <br />Total Postage & Fees <br />m <br />Sent To <br />C3 AlAW '7 <br />r_3 Mi?f-AiYEW / <br />or PO Box No.1O) <br />__ ?? -` SfoZOQ <br />City, State, ZIP+4 <br />y 40 4AW <br />PS Form 380C?, August 2006 See Reverse for Instructions <br /> <br />102595-02-M-1540 <br />- - - - - - Spec. Pojlf <br />I Certified Mail Provides: File # ;r1 1 %al//r5 <br />¦ A mailing receipt a ?WA? <br />¦ A unique identifier for your mailpiece ??? <br />¦ A record of delivery kept by the Postal Service for two years <br />Important Reminders.- 41-060 rove- <br />0 Certified Mail may ONLY be combined with First-Class Maile or Priority Mai <br />¦ Certified Mail is not available for any class of International mail. <br />¦ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. F <br />valuables, please consider Insured or Registered Mail. <br />¦ For an additional fee, a Return Receipt may be requested to provide proof i <br />delivery. To obtain Return Receipt service, please complete and attach a Retuw <br />Receipt (PS Form 3811) to the article and add applicable postage to cover it <br />fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver fx <br />a duplicate return receipt, a USPS® postmark on your Certified Mail receipt <br />required. <br />¦ For an additional fee, delivery may be restricted to the addressee <br />addressee's authorized agent. Advise the clerk or mark the mailpiece with tl <br />endorsement "Restricted-Delivery". <br />¦ If a postmark on the Certified Mail receipt is desired, please present the ar <br />cle at the post office for postmarking. If a postmark on the Certified Mi <br />receipt is not needed, detach and affix label with postage and mail. <br />IMPORTANT- Save this receipt and present it when making an Inquiry. <br />PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047 <br />ORMS-1313 Sherman. Rm 215. Denver, CO 80203