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<br />J <br />Z 217 446 297 <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Dn not use for Intemational Mail /Sew ravarsel <br />a <br />0 <br />O <br />M <br />0 <br />LL <br />a <br /> <br />Selll to I <br />SIr e18 Numbe~ ~ ~ <br />Post Office, State, d IP ode ~ ~~ ~ n <br />Postage $ ~ <br />• J, <br />Certified fee ~, ~/ ~I <br />Speaal Delivery Fee <br />Restncletl Delivery Fee <br />Retum Receipt Showing to <br />WhomBDateDefiverad , ! ~ - <br />'~ <br />fleNm flxept 5tawng to Vifnm, <br />Dale, 6 MNessee's Adders <br />TOTAL Postage 8 Fees $ ~' I C r ~' <br />Postmark or Dale <br />~7 <br />Z 217 446 291 <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Do not use for International Mail See re <br />Postage <br />Canihed Fee <br />Spedal DelNery Fee <br />Restricted Delivery Fee <br />N <br />O1 Re1um Receipt Showing to <br />rn <br />Whom 8 Dale Delivered <br />• <br />SENDER: I also wish to receive the <br /> <br />•Camplele aemslantl/or 2lor atldilionai serves' <br />C <br />l <br />1010'NID Sen/ICea fer an <br />g ( ~ <br />. <br />omp <br />ete hems 3, 4a, antl 4b <br />• Print yom name antl atltlress do the reverse of Ihis loan so Thar we can return Ines extra tee): <br />card to you. <br />• Attach this form to the host of me mailpiece. or on ine back it space dues not <br />1. ^ Addressee's Address <br />perms <br />• Write 'Return Receipt Requesletl'on the mailpiece below the ankle number 2. ^ Restncted Delive <br />ry to <br />• The Reurn Receipt will show to whom the article was delivered antl the tlate <br />C <br />l[ <br />t <br />t <br />f <br />l <br />deevered. onsu <br />pos <br />mas <br />er <br />or <br />ee. $ <br />to: <br />ADams County <br />Department of Public Works <br />4955 ast 74th Avenue <br />Commerce City, CO 80022 <br />5. Received By: (Print Name) <br />x ~~.ivv~ ~~ <br />PS Form 3811, December 1994 <br /> <br />4a. Anlcle Number v <br />Z 217 446 297 <br /> c <br />4h. Service Type ~ <br />^ Registered G]{Cenifled u <br />^ Express Mail ^ Insured ~ <br />^ Retum Receipt for Merchandise ^ COD ~ ~ ~. <br />7. Dale of Deliv ~ry , ^ <br />l ~U 5 <br />o <br />O r <br />8 Addressee's Atl ress (Only i ! requested m ~ <br />and /ee is paid) m <br />99-254 2/2/00 <br />f <br />r0259598~9~e229 Domestic Heturn Receipt <br />/ °' SENDER: <br />d <br />L~ i O .Complete hems t anrLOr 2 for additional servmes <br />a • Complete items 3, da. and 4b. <br />d . Pnnl your name and address on the reverse of Ihis lone so Thal we can return mis <br />'{' Ufa u card to you. <br />[~ ~ .Attach Ihis form to the honl of the mailpieca, or on the back it space does not <br />la. O LC"J ~ O • Wnta t'Rerurn Recerpl Requesled'on the mailpiece below Ise ankle number. <br />O • The Return Receipt wJl show to whom the amde was delrveretl antl the date <br />$ ~ ~ -~' tleirveretl <br />,_~ 7 <br />0 3. Article Addressed to: 4a. Article <br />~~ Lr I d South Adams County Water. & <br />O TOTAL Pelage 8 Fees $ <br />m <br />~ Postmark or Date <br />0 <br />LL <br />a ~ ~,,, -~ ~'- <br />/'/ - _ , <br />I also wish to receive the <br />fOIDWtng SBrviCBS (loran <br />extra tee): <br /> <br />1. ^ Addressee's Address u <br />2. ^ Restricted Delivery ti <br /> <br />COnSUt DOStmastef fnf lee. n <br />tber <br />r rl ~ ,~/ / 1 ~7 <br />I <br />-! E SanltatlOR D15tr1Ct <br />of Denver <br />& Count <br />Cit 4b Service Type ~~~t// ~ <br /> o y <br />y ^ Registered Id~Certified <br /> 6595 East 70th Avenue ^ ExpressMail ^ Insured ~ <br />~7~ ~ Commerce City, CO 80022 ^ Return Receipt for Merchantllse ^ COD ~ <br />~'~I 7. Date of Delivery <br />~'_ <br />~ <br /> <br />~ ( <br />` <br />~ o <br />G ,.j- 5. Received By: (Print Name) 8 Addressee's Address (Only it requested x <br />~ and lee is paid) n <br /> <br />6 Signature: (Addre or Age t <br />~ <br />o' X 99-254 2/2/00 <br />r <br />' <br />C <br />- <br />~ <br />' !" PS FDfm 81 ecember 4 1025959890229 Domestic Return Receipt <br />