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• Complete items 1, 2, and 3. Also comp <br />Item 4 if Restricted Delivery Is deslml¢ <br />• Print your name and address on the 0averse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailplece, <br />or on the front If space permits. <br />1. Artl "Addressed to,. <br />Minnesota Canal & Reservoir Company <br />41103 Lamborn Mesa Rd <br />Paonia, CO 81428 <br />A- Slgnatu 1 <br />X � r.� <br />R Printed Name) Da ot D01113i <br />D. Is delivery addre6 46rent from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />rti(ied Mell <br />❑ rees Mall <br />Registeredetum <br />Receipt for Merchandise <br />❑ Ensured Mall <br />❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Artich 7012 1640 0000 1628 5661 <br />Rte+= <br />PS Form 3811, February 2004 Domestic Return Receipt 102505.02 -M -1540 <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 mallpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Mr. Levi Broyles, District Ranger <br />USDA Forest Service <br />Paonia Ranger District <br />P.O. Box 1030 <br />Paonia, CO 81428 <br />A. Signetu <br />� Agent <br />X ❑ Addressee <br />B. Received (Printed Name) C. Date of Delivery <br />D. Is delivery eddrndffkr,,t frd:ml a Yes <br />If YES, enter dqKery es ❑ No <br />I <br />N <br />3. SArvice Type <br />r Certified Mell Mall <br />❑ Registered �eturn Receipt for Merchandise <br />❑ Insured Mall ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2.Ar 7012 1640 0000 1628 5654 <br />rn <br />PS Form 3811, February 2004 Domestic Return Receipt toms- m-M -luo <br />