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^ Complete Rems 1, 2, and 3. Also complete A: <br /> <br />Rem 4 'rf Restricted Delivery is desired. ~~~ <br /> <br />X <br />.Agent <br />^ Print your name and address on the reverse ^ Addressee <br />so that we can return the card to you. g, Received by (aimed Name) c. Date of Delivery <br />^ Attach this card to the back of the mailpiece, L~ _~ <br />^ <br />or on the front if space permits. 7 <br /> ~ ^ Yes <br /> D. is delivery eddtess 77 <br />t. ArtiGe Addressed ta: If YES, enter d ^ No <br />Bobbie D. Grett ° ~~ <br />2025 Tabor Dr. <br />Lakewood, CO 80215 a_s~rW~erype ~pS <br /> I7~3 Certified Mail aii <br /> ^ Registered ^ Return Receipt for Merchandise <br /> ^ Insured Mail ^ C.O.D. ` <br /> 4. Resfrlcled Deliveyl (Extra Fee) ^ Yes <br />2. ArtlUeNamber 71704 251Q 0004 $298 4363 <br />(frans/er Irom serNCe label) <br />PS Form 3811, February 2004 Domestic Return Receipt tozsssce-M-tsac <br />~ Complete Rems 1, 2, "and 3. Also complete <br />hem 4 H 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 !roM H space permits. <br />1. Article Addressed to: <br />^ ggeM <br />rl e.tn~~ '~ <br />B. Received M' (Rirrted Name) C. Date of DetNe'ryy . <br />l-y~u,U M U~e,~fe,^s ~-! 9-a 5 <br />D. b delNery address diRereM from kern 1? ^ Yes ' <br />N YES, enter delivery address below. ~ ^ No ; <br /> <br />Black Hawk Central City ~ <br />Sanitation District <br />P.O. Box 362 <br />II Black Hawk, CO 80422-0362 I 3. Servke Type <br />--~meeMml ^E,~„asaMan <br /> b Registered ^ Return Receipt fdr MerchaMise <br />_ <br />_ ~ ~ - ^ Insured Mail ^ C.O.D. <br />' 'y' _ 0. Restricted Delivery/ (tea Free) ^ Yes '. <br />2: Attide Num r <br />~y~°!I l~l ~~~I ~ s I <br />7Q174 25117 OOQ4 8298 4417 i <br />I PS Fonn 381;1, February 2004 , . Pomest(c Rewm Receipt- - " ~ tmsssoz~n-tsa r <br />^ Complete Rems 1, 2, and 3. Also complete <br />Rem 4 'rf 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. Artlde Addressed to <br />A Sign lure <br />X ^ Agent <br />Addre <br />e. Receive (Printed Name) C. D P of Del <br />•D.Isr~IFvery address diRerentiromStem l? ^Yes <br />RYES, emer delivery address below: ^ No <br />Clear Creek Convenience, LLC <br />60 <br />i <br />h <br />way <br />g <br />20203 H <br />Platteville, CO 80651 a: sa IoeType <br />~ <br /> CertNed Mail ^ Express Mail <br /> ^ Registered ^ Return Receipt for Merchandise <br /> ^ Insuretl Mail ^ C.O.D. <br /> 4. Rasbicted Deliveryl (ExVa Fee) ^ Vas <br />2. AdicleNumtter 7004 2510 0004 8298 4394 <br />(rwrs/er /mm seMce laben <br />PS Fonn 3811, February 2004 Domestic Rehm Receipt tozsasoz-ni-tsao <br />