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Byron 6 LaLani Weathers • <br /> Weathers Mine #1 <br /> Soil Conservation District — Proof of Filing <br /> o- ER: <br /> $ •Complete Items t andfor 2 for additional services. I also wish to receive the <br /> e •Compete Memo 3,4a,and 4b. following services(for an <br /> •Pdm your name and address on the reverse of this form so that"can Mum this extra fee): <br /> card to y�oou. <br /> •permit.this form to the from of the mallpece,ar on the bad If space does not 1. ❑ Addressee's Address �•o <br /> 8 write'Relurn Receipt Requested'on the malipem below the article number. 2, ❑ Restricted Delivery Qj <br /> -The Rolm Receipt will show to whom the article wee delivered end the date <br /> o delivered. Consult poehnester for fee. <br /> 0 <br /> y 3.Article Addressed to: 4a.Article Number <br /> g /Vl3• PENNY I�'/6KGL8u/K. P $lv6 /Z(o 977 E <br /> 4b.SerAce Type <br /> Registered ! Certified is <br /> .SO A/Z D O r SuPEIL rscii <br /> reso Mau ❑ Insured e <br /> P O. Box io6 ❑ Recellft for Merdtandse ❑ COD <br /> 7.Daten Dative <br /> 5.Received By: (Print Name) to 8.Ad so's A dres (Only If requested <br /> e upald) 9 <br /> 6.SI eture;(Addressee or Agentr. F <br /> el <br /> dNm <br /> Ps Form 3811, December 1994 Domestic Return Receipt <br /> PS Form 3800,April 1995 <br /> T y 3 m a yo y o o �w <br /> a. c 2I 'X o oa no a <br /> ra ' o- c N r1i <br /> R R to <br /> p� c <br /> p�. 3m 'em G' <br /> $ s 8mm m <br /> M J m g � N <br /> • ;t n- <br /> ur re � °—• <br /> a �1 <br /> to' r. ^t <br /> m <br />