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¦ 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 />1. Article Addressed to: <br />I City of Walsenbur <br />1. g <br />525 S. Albert <br />Walsenburg, CO 81089 <br />A. Sig ure <br />X ? Agent <br />? Addressee <br />Recei ed b Z tinted Name) C. Date of Delivery <br />S /--,- J 25 2010 <br />D. Is delivery address different from item 17 ? 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 <br />(r 7008 3230 0002 7252 .6421 <br />(Trans sferr from rom service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />r9 R. - • . . . . •. <br />ni <br />_" <br />Ln Postage: $0.44 <br />ru Certified Fee: $2,80 <br />r Return Receipt Fee: $2.30 <br />ni ark <br />o Total Postage & Fees: =$5 54: <br />ti <br />C3 <br /> (Endorsement rregwreot <br />C3 <br />M <br /> <br />r1.1 <br />Total Postage & Fees $ <br />M <br /> <br />Co <br />Sent To <br /> <br /> <br />it <br />of Walsenbur <br /> <br />C3 <br />fi[rees AF(?0F, <br />B y <br />g <br />525 S <br />Albert -------- <br />'` oxNo. <br />vrPO <br />--- . <br /> C?;Siate,2W Walsenburg, CO 81089 <br /> PS Form :3800, August rr. <br />UNITED S <br />MMI 11110011 SPS <br />• Sender: Please print your name, address, and ZIP+4 in this box • <br />STATE OF COLORADO <br />(DEPARTMENT OF NATURAL RESOURCES <br />DIVISION OF RECLAMATION,; MINING & SAFETY <br />I 1313 SHERMAN. STREET, SUITE 215. I <br />DENVER. CO 80203-2273 <br />341300000 Spec. W0 <br />File # M.- auop-v91 <br />` o <br />7?? C6 <br />4e <br />U op <br />Certified Mail Provides: <br />¦ A mailing receipt SPOIC. tAr . <br />¦ A unique identifier for your mailppi?e,c?e 1 <br />¦ A record of delivery kept by ther-Y a #r1?ll? for r }ra ` <br />Important Reminders: <br />¦ Certified Mail may ONLY be combined with First-Class Maile or Priority Mail, <br />¦ Certified Mail is not available for any class of international mail. <br />¦ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo <br />valuables, please consider Insured or Registered Mail. <br />¦ For an additional fee, a Return Receipt may be requested to provide proof a <br />delivery. To obtain Return Receipt service, please complete and attach a Returr <br />Receipt (PS Form 3811) to the article and add applicable postage to cover the <br />fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver foi <br />a duplicate return receipt, a USPSe postmark on your Certified Mail receipt ie <br />required. <br />¦ For an additional fee, delivery may be restricted to the addressee o <br />addressee's authorized agent. Advise the clerk or mark the mailpiece with the <br />endorsement "Restricted Delivery". <br />¦ If a postmark on the Certified Mail receipt is desired, please resent the arti <br />cle at the post office for postmarking. If a postmark on thpe Certified Mai <br />receipt is not needed, detach and affix label with postage and mail- <br />IMPORTANT. IMPORTANT. Save this receipt and present it when making an inquiry. <br />PS Form 3800, August 2006 (Reverse) PSN 7530-02.000-9047 <br />DRN,?IS-1313 Sherman, Rm 215, Denver, CO 80x203 <br />first-Class Mail <br />ostage 8r Fees Paid <br />Permit No. G-10