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REV91158
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REV91158
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Entry Properties
Last modified
8/25/2016 3:12:45 AM
Creation date
11/21/2007 11:09:22 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977436
IBM Index Class Name
Revision
Doc Date
7/10/2000
Doc Name
CONSTRUCTION MATERIALS REGULAR 112 OPERATION RECLAMATION PERMIT APPLICATION FORM
Type & Sequence
AM1
Media Type
D
Archive
No
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C~ <br /> <br /> <br />^ Complete kems 1, 2, and 3. Also complete <br />kem 4 k Restdcted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can Tatum the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the hoot k space pennks. <br />1. Article Addressed to: <br />Adams County Soil Cons. District <br />57 West Bromley Lane <br />Brighton, CO 80601 <br />Received by . P`nn_t Cleerty/ J~I~o~ir ~` <br />~vvt c'o er3~.il ry ~( 1 <br />e _ ^ Apent <br />D. Is divvy address tlilfvva from aem 19 ^ Yes <br />k YES, enter delivery address below: ^ No <br />3. Service Type <br />~Cvafletl Mall ^ Express Mail <br />^ Repislered ^ ReNm Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restrkted Delivery) (Extra Fee) ^ Yes <br />2. Article Number (Copy hom service late <br />X099 3220 ooa5 250 3895 <br />PS Fonn 3811, July 1999 Domestic Retum Receipt <br />10259S99~M~1]99 <br />.< ._..:?yy:!`q: .. a~ .~ ~+.-",- . .. ~'n:.:.-t~:-h 'CvYS:~a~3i _a •:i;F$;Y..b :... y:J> :~1 ~_y,,..wcc!'#i:.:">,~... ~°!:i ~a~ .eq?^,!>`:~:i :::'Y .. <br />^ Complete kems 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this rard to the back of the mailpiece, <br />or on the front if space pennks. <br />1. Article Addressed to: <br />Adams County <br />Board of County Commissioners <br />450 South 4th Avenue <br />Brighton, CO 80640 <br />A Received by (Freese JU 1 _x(10 INery <br />C. ~ ' ~- <br />// _ e <br />Addressee <br />D. Is delNery add d~~ mm kem 1? ^ Yes <br />e YES, mtv delivery address below: ^ No <br />3. Service Typo <br />i8~ertified Mail ^ Express Mail <br />^ Repisteretl ^ Retum Recelpt Iv Merchandise <br />^ Insured Mail ^ G.O.D. <br />4. Restricted Delivery? lEx'fie Fee) ^ Yes <br />2. Article Number (Copy !mm service label) <br />~ogq 3azo ooos 250 39of <br />PS Form 3811, July 1999 Domestic Rekrn Receipt 10259S99~M~1769 <br />REC~rVCD <br />.':~~ 10 2000 <br />pivi~ Dr -' t~ ~e-als 8 Ger'^~~ <br />
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