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^ Complete items t, 2, antl 3. Also complete A Sisrm a <br />kern 4rf Restricted Delivery is desired. <br />x ~Ageni <br />^ Print your name end address on the reverse o ° ^ Addre <br />so that we can return the card to you. <br />• ^ Attach this card to the back of the mailpiece, g, q~ry~ by tpdarod Name) C. Date of Dali <br />/~ <br />or on the front H space permits. <br /> D. IS dNivery address 17 ^Yes <br />1. Article Addressed to: H y~ eraer ^ No <br />r 1 <br />LJ <br />Bobbie D. Grett ° ~ <br /> <br />2025 Tabor Dr. ~ <br />Lakewood, CO 80215 a.~te Type ~ <br />~ <br /> Cenifwd Mail ail <br /> ~ Registered ~ Return Receipt br Merchandiss <br /> ^ Insured Mall ^ C.O.D. <br /> 4. Resbictad Delivery? (Extra Fee) ^ Yes <br />z. ArtideNranber 7Q04 2510 0004 8298 4363 <br />(fra+rsler horn asrvfce IabeQ <br />PS Form 3811, February 2004 Domestic Return Receipt 7075ssaz--Ftsa <br />~ Complete items 1,.2,.antl 3. Also complete A SI nature <br />Ham 4 N Restricted Delivery is desired. <br />' - ^ Agem <br />i <br />X ~ <br />I ~ Print your name and address on the reverse _ c ~ _ (.(1.,.~LR//a. <br />p Atldressee <br />so that Wa can carom the card to you. B. ReceNetl by (Pdnted Namej C. Data of DeIN~ <br />a mallplece, <br />~ <br />^ <br />s <br />c ~° /S <br />~y~N M U•e x ~-( g'(J S <br />ttre fro ff <br />or on <br />pace pe <br />rmits _ <br />. <br /> ' <br />^ <br /> Yes <br />D. is delivery adtlress dA/aent from Hem 77 <br />11. Arlide Addressed to: <br />- <br />I __ .__.. ... .._ .- __. _._._..._ __~~.~ _ !f YES, enter defiuery address bebw: ^ No <br />_ <br /> <br />~ Black Hawk Central City - <br />~ Sanitation District <br />P.O. Box 362 s. semoetype <br />~ Black Hawk, CO 80422.0362 --;Hadmm~ p6cpresyMeil <br />i ^ Registeretl ^ Return Receipt tot Merchandise <br />~ - ~ ~ Insured Mao ^ C,O.D. <br />~ - - ~ 4. Restricted Delvery7 (Extra Fee) ~ ^ Yes <br />2. Artice Number !j I+! '~~ 7004 <br />i 2510 0004 8298 4417 , i <br />(rrarrs(erlmm serNoa fa6en . <br />I PS Form 3811, February 2004 Domestic Return Receipt tozsssoz-Md59o r <br />s • • • r ~ . <br />^ Complete Hems 1, 2, and 3. Also complete A Si tore <br />item 4'rf Restdcted Delivery is desired, X ~ F' ~ Agem <br />^ Print your name and address on the reverse Addresse <br />so that we can return the card to you. g. Receive6 ! p ~nled Name) c. D of Deriver <br />^ Attach this card to the Uack of the mallpiece, / ~- <br />or on the front if space permits. <br /> A Is ad ress dAFerent from 17 ^ Yes <br />t. Aside Addressed to: It YES. enter Aelvery address ttebw: ^ ~ <br />Clear Creek Convenience, LLC <br />20203 Highway 60 L <br />Piatteville, CO 80651 s. sarwce type <br />~Certlffed Marl ^ Express Mal <br />^ Registered ^ Return Receipt for Memhmrdise <br />^ Insured Mail ^ C.O.O. <br />4. Restricted Delivery) (Extra Fee) ^ Yes <br />Z. Article Number 7(]04 2510 OQQ4 8298 4394 <br />(Fransfer ham service label) <br />_PS Form 3811, February 2D04 Domastlc Return Receipt tozseso2~tsao <br />