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• ^ Complete hems 1, 2, and 3. Also complete <br />hem 4 H Restricted Delivery Is desired. <br />~ Print your name and address on fhe 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 h space permhs. <br /> D. Is delivery addres dMererrt from hem 1? ~ Ves <br />t. Article Addrevsed to: If YES, enter delivery address below ~ No <br />Jefferson Conservation District <br />Sally Lobel, District Mgr. <br />655 Parfet St., Rm E-300 rvice type <br />a. <br />se <br />Lakewood, CO 80215-5517 r <br />~vv <br />Oa,CeRifetl Mail ^ Express Mail <br />b <br /> Registered ^ Return Receipt for Merchandse <br />^ IrGSUred Mail ^ C.O.D. <br />A Sg/n~ature / ,Q <br />X K1 L~ V122C)~ n~~~t• <br />B. Received by (Panted Name) I G, Daie of ~ ~ry <br />4. Resbicted Delivery/(Extra Fee) ^ Ves <br />2. ArucleNum6er 7004 2510 0004 8298 4035 <br />(riansfer from seMce labdl <br />PS Form 3811, February 2004 Domestic Return Receipt iozsssuz•M-tsw <br />^ Complete items 1, 2, and 3. Also complete <br />hem 4 it Restricted Delivery 4s 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 maflpiece, <br />or on the front if space permits. <br />A <br />X <br />~~ <br />• 1. Article Addressed to: <br />Board of County Commissioners <br />Gilpin County <br />203 Eureka Street <br />Central City, CO 80427 <br />~~8.--``Receved by (Pdnted Name) G. Date of Delivery <br />~'1QrGr~ C.~'it~ y~J{+i0s <br />D. is delivery address diHererrt horn hem 17 ^ Yes <br />If YES, enter delivery address below: ^ No <br />3. Typo <br />ed Mail ^ Express Mall <br />^ Regstered ^ Relum Receipt for Merchandise <br />^ Ir>sured Mail ^ C.O.D. <br />4. Restrkted DelNery! (Exh'a Fee) ^ Yes <br />2. AdicleNUmt>ar 7004 2510 0004 8298 4042 <br />(rrartsfer from service labeq <br />PS Form 3811, February 2004 Domestic Return Receipt 10259502-M-1540 <br />