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^ Complete ttems 1, 2, and 3. Also complete <br />item 4 tt ResMCted 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 />11. Article Addressed to: <br />' Jefferson Conservation District <br />' Sally Lobel, District Mgr. <br />655 Parfet St., Rm E-300 <br />'. Lakewood, CO 80215-5517 <br />A Signature J nn <br />X <br />v <br />L ~ <br />~ <br />t <br />1 fi <br />. <br />IK ^~ <br />B. ReceNed by (Pdnted Nartre) C~, D <br />ate <br />of <br /> <br />!~ l <br />/ <br />' <br />/t/ <br />D. is delvery address ddrererrt horn ttem 17 ^ Ves <br />tf YES, enter delvery address below: ^ No <br />3. Service Typo <br />~CertMied Mall ^ Express Mail <br />Registered ^ RaNm Receipt far Memhandise <br />^ Insured Mall ^ C.O.D. <br />4. Restricted Delivary7 (Extra Fee) ^ Yes <br />2. Art1cleNumber 7004 2510 0004 8298 4035 <br />(frans/er ham aer,~lce ~ <br />PS Form 3811, February 2004 Domestic Return Receipt toussos+.r-tsw <br />^ Complete items 1, 2, and 3. Also complete <br />item 4d Restdded 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 'rf space permits. <br />1. Argcle Addressed to <br />Board of County Commissioners <br />Gilpin County <br />203 Eureka Street <br />Central City, CO 80427 <br />I <br />A Si nature <br />X ~~~~PL~~ Agent <br />^ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />D. is delivery address different horn ttem 17 U Yes <br />a YES, enter delivery address below: ^ No <br />3. Se ce Type <br />ed Mall ^ Express Mall <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Ma(I ^ C.O.D. <br />4. Resfrkted Deliver7/1 (Extra Fee) ^ Yes <br />' z, AniseNUmber 7004 2510 0004 8298 4042 ' <br />I (rra~rhom:~eiaaeq <br />I PS Form 3811, February 2004 Domestic Return Receipt 7o25s5o2-M-759o <br />