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A.Signature: (C Addressee nr A;9!! _ <br /> •Ensure items 1,2.and 3 are completed. <br /> •Attach this card to the back of the mailpiece,or on <br /> the front if space permits. <br /> B.Received By:(Printed Name) C.Date of Delivery <br /> 1 Article Addressed to: D.3s de0very address different from Rem 17 Yes <br /> Suite 160 If YES,enter delivery address below: <br /> Teller-Park Conservation District <br /> 800 Research Dr '� <br /> i <br /> Woodland Park CO 80863-9732 <br /> 7 <br /> i <br /> I <br /> �MM Ii I� 3.Service Type <br /> ✓ Certified Mail-P I <br /> 9490 9118 9956 1537 8357 34ag� <br /> 2.Article Number+7ransfer from service IaDeli n,� i <br /> 9414 7118 9956 1537 8357 85 ! " <br /> 10- <br /> PS Form 3811 Facsimile,July 2015(SDC 3930) Domestic Return Receipt <br /> -" A. Lure: (�Aa s s or O Agentj" ^"' ''• <br /> •Ensure items 1,2,and 3 are completed. <br /> ■Attach this card 10 the back of the mailpiece,or on <br /> the front if space permits. <br /> Received By:(Printed rJamw C:it <br /> 1.Article Addressed to D.Is delivery address different fr6rn item 11 Yes <br /> 8tc�,7,rd of r,3un <br /> If YES,enter delivery address betQM .. Nb <br /> Park louny4 <br /> !9iox 1-37wfitva <br /> t�;� � 7� ,' w�!�•�� ) r t� � ' �� 3.Service Type <br /> l <br /> 2.A:tiyie Nu"r(Transfer from service label) <br /> PS Form 3811 Facsimile,July 2015(SDC 3930) Domestic Return Receipt <br />