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Hall-Irwin Corporation -Nissen Farm Resource MLRB 112 Application <br />u"I <br /> <br />fU <br /> <br />~ Postage $ <br />r <br />m <br /> <br />m Cert'rfled Fee <br />~ Retum Receipt Fee 7S <br />O <br />~ (Endorsement Required) <br />O Reshkted Delivery Fee <br />~ (Fndorsemetrt Required) <br />o Tomt voata9e Jt Feea $ G/ <br />m <br />fn <br />'~ r ro <br />--- ecCt_- ~!~-~ ~-~------ <br />Str <br />t <br />A <br />N <br />~ <br />o ee <br />, <br />PL <br />o.; or O <br />~a <br />~~a x o. <br />e~~ <br />1?~~~y <br />r <br />~ <br />. <br />M1 > <br />_ <br />~.> <br />. <br />------ <br />C/p~Stat, P«4 %y ,~~~~~~ <br />) l_ 1~ <br />nJ <br />~ Postage $ p <br />GMO.tir t` O'~'"f> . <br />~~,~~~~J~(.G'~ ~ Certleetl Fee p ~ ~ ~ ~ ~,~. ~ <br />'"H11OM/~ ~ ~ Retum Receipt Fee JJ~S ~~ P~~• <br />cn ~ (Endorsement Requlredj 1 , <br />~ O Resaicted f livery Fee ~ , (v - _ <br />~~ O (Endorserq{,.rt Required) ~j S~ ~' ; ~/ <br />S.as 0 Total Postage 6 Fees $ B Qy ~\ - ~ / <br />m (iLJ <br />Jn S tTO \ <br />,'_____""""'-' ~ Street, APL No.; or PO Box No. <br />CI fate,D «4 <br />ra <br />~ Postage $ ~ ~~~-:~ <br />r- <br />~ <br />m <br />m Certified Fee -i <br /> <br />~ <br />~ <br />Retum Receipt Fee <br />(Fndorsemerrt Required) / P <br /> <br />~ ( <br />O Restdoted Delivery Fee (~O <br />• <br /> <br />~ <br />(Endorsemaie Regained) / <br />G <br />p Total Postage & Fees $ G ~ / <br />SAS, <br />/ <br />m <br />i~etlf_En~-- `--- - ~~~P~~ _~ P... <br />p Streeq APL Na.; or P~~a. <br />0" <br />~ <br /> <br /> <br />S y <br />E <br />fU <br /> <br />~ Postage <br />F~ <br />m <br />m Certified Fee <br />~ Retum Receipt Fee <br />~ (Endorsement Requited) <br />O Resirktetl Delivery Fee <br />'O (Endorsemem Required) <br />O Total Postage & Fees <br />m <br />Lr] <br />~ Sen! <br />~~~ <br /> <br />~ <br />0 _- <br />._ <br />StieaR Apt No.; or O <br />1D9Q <br />!~~ <br />r` . __ <br />cr~rate^iiv«a.^ <br />Proof of Public Notice Mailing Page 8 of 8 <br />