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REV01741
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REV01741
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Entry Properties
Last modified
8/25/2016 12:59:18 AM
Creation date
11/21/2007 8:54:55 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1983084
IBM Index Class Name
Revision
Doc Date
2/28/1996
Doc Name
APPLICATION FORM
Type & Sequence
AM3
Media Type
D
Archive
No
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i <br />• <br />EXHIBIT R <br />PROOF OF FILING WITH COUNTY CLERK AND RECORDER <br />Z .~&4-44 7 6 3 L <br />Receipt for <br />Certified Mail <br />No Insurance Coverage Provided <br />~~ Do not use for International Mail <br />"'"'rM' ISee Reversal <br />m <br />L <br />Y <br />m <br />0 <br />0 <br />m <br />E <br />0 <br />LL <br />N <br />a <br />nt io <br />$1~¢PI antl Ne <br />1 <br />P Sraie an ZiP COtle ( fO <br />Posia9e $$ O <br />Cend¢tl Fee <br />$pP[~al DelrverY Fee <br />neslnCletl DNnery Fee <br />aewm eeceipi Snowing <br />~0 Wnom 6 Dala Delneieo <br />I , <br />eelprn eeceipi Snpw~np io Wnom, <br />Ddle. antl Atl0leSSee'a AOEre55 <br />rorAt Ppsidye <br />a Feee $~ n1 <br />l.J <br />Postmark or Date <br />~~-~~ <br />~~-~lac~ <br />RE(;FivED <br />~g 2 8 1996 <br />BlviCion vi Minoralp & QCOIOQ'/ <br />o SENDER: <br />9 •Camgele uerro 1 ird'« 2lcr.dQNOrW wrvicee. I eI50 MrISb IO reCBIVB Ule <br />~ .C«rglete Hems s. u, uttl ~h. fdlovring seMces (tor en <br />~ •Ptlrq yo« wrr erd .tltlrm. m the nvene of Nis Nrrri a that wa can slum W. wdra f0e): <br />tatl to pu <br />o •M~ uiis arm lour tr«r d Ne mYlpiece, «m tlr Dark tl .pace tloea nd 1. ^ Addressee's Address E <br />o . Wma'Retum Rxniq Raqunletl'on ar rtvulpiece trlop Ne elide rnniber. Q, ^ ResMCted DeIIVery <br />.17r Relum Receiq wit Yaw to Namur erlide wet tlaiverW antl V» tlata <br />~ aNiveretl. ConsuR postrnaster for fee. <br />o !t <br />v 3. ArECIe Addre(1ss~ed~W: 4a Article Number i <br />~1~( ~~ Vq!-1.x(1 ~ Q.aCI~ <br />E `"~ k~` 4b. SeMce Type <br />~~ - MQ; tiJ CG~ ^ Registered ~ertifled <br />~ K t~~ `a " f ~ R E ~E I V E Date~ol Delfveryr MerdFendse ^ I D d ~ <br />5. Received By: (Pdnf Name) Addressee's ass jOnly i! requested <br />( end tae fs paitl)i1~MG l~p~- r ~' <br />;; <br />e <br />PS Form 3811, December 1994 t)omestlc Retum eCeipt <br />R-I <br />
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