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REV00030
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REV00030
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Entry Properties
Last modified
8/25/2016 12:57:45 AM
Creation date
11/21/2007 8:42:41 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1984063
IBM Index Class Name
Revision
Doc Date
9/7/1995
Doc Name
LANDOWNER PROOF OF SERVICE PHASE I BOND RELEASE APPLICATION
From
BALAZ & ASSOCIATES INC
To
DMG
Type & Sequence
SL1
Media Type
D
Archive
No
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• <br />°' SENUER: <br />~~ <br />y Complete items 1 entl/or 2 for eeditlonel services. <br />I a160 WISh (O IBCEIV9 the <br />~ <br />. O • Complete irome 3, end 4e 8 h. (pllOWlne 6erVICB9 ((Of Bn B%tra V <br />• print yow nem• sne eedran on the roveru o/ this loan so that w• een <br />m <br />hl <br />e }901' <br />~ <br />Z <br />return t <br />e car <br />to you. <br />• Attach this form to the front of the msilplece, or on Ne Deck ~If specs <br />1. ^ Addressee'6 Addres6 ' ) <br />M I <br />tlpes net permit. <br />o <br />" <br />" <br />~ •, t <br />• Write <br />Return Receipt Requestee <br />on the msllpiece below the ertlcle number. <br />2. ^ Restricted Delivery t1 <br />• Tha Retum Receipt will show to whom the article wee eeliverae entl the sets O <br />~ <br />c eellve,ee. Consult ostm9ster for fee. ¢ ` <br />Articl <br />A <br />re <br />sse <br />. <br />e <br />dd <br />d t <br />: <br />9m 3 <br />o/ 4a. Article N <br />79 o s~7 <br />ulm~b+er I <br />,~/ <br />~ <br />J~f <br />/ <br />~ <br />,,( A <br />/ <br />O <br />~ <br />/ <br />~ <br />~rr <br />' <br />tl a <br />~ <br />z~T/ ' <br />a ///5 <br />//G ~ <br />-'/'-aft `~i %~f%ri/t <br />E <br />' 46. Servicft Typ ^~-, - ~ <br />^ <br />d' 2 <br />~ .; ~ <br />/J~~~/! ~ Regi Bre <br />r. u Insured ~ I <br />y er ' ~ ^ COD ~ <br />2 <br />H ~ t~ /l ~x Sc~s ~ ^ Return Receipt for ~ ' <br />¢ erchandise <br />:, Q / <br />"` 4 <br />( ~ `° <br />~/ t2 ' ~C r 9 <br />giver >~ - <br />7 <br /> 3 <br />Y <br />r <br />9.t7Y ~ <br />U <br />\ o <br />. ¢ 5. u dresses 8. ass dre (Only if reQUested <br />i <br />Y <br />,> <br />~ ~ d c <br />= <br /> V .S <br /> <br />? , <br />H PS Form 3 17, December 7991 cu.s.cpo:t~a-asxat~ DOMESTIC RETURN RECEIPT . j <br />,~ t <br /> <br />• <br />J <br />~. <br />i <br />
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