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REP05601
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REP05601
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Entry Properties
Last modified
8/24/2016 11:36:25 PM
Creation date
11/26/2007 11:07:43 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1994114
IBM Index Class Name
Report
Doc Date
11/18/1997
Doc Name
ADMINISTRATIVE RECORD
Media Type
D
Archive
No
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- Z 239 765 094 <br />US PosW Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Do not use for Intematlonel Matz )See reverse) <br />Sem to <br />Sme18 NU Bleke L. Mitchell <br />7763 County Road 38 <br />Pat Offioe, Mancos, CO 81328 <br />Postage S .~-3-~.5 <br />Csttifiad Fee ~ _ 3 <br />6pedal Delivery Fee <br />Reseided Delivery Fee <br /> <br />~ ReNm Reodq Bfpwinp to <br />vmem a oau Oe~ve <br />liee•n 11~ . o <br />I D <br />Dee, 6 Adtr . <br />TOTAL P Q 8 Fee <br />~ n ,~ <br />~ Pastnwk J <br />° 1997 <br /> <br />~ , . UEPS , <br /> <br /> if t <br />j e SE DER: <br /> <br />' a .Compete 9eme 7 endor 2 fa etldttlonal esrviae. 19150 wish 10 receive the <br />~ ~ • .comp.. norm s, se. and u. ~ following services (tor an <br />M1. g •Prlm ywr near vd eedrpe on tM nrn• of Mn form w tlut wa un tslum tti• exh9 fee): I <br />_ <br />.. ~ <br />k C <br />s nrd to you. <br />•At1eN Itue loan to IM hoot of tlu nieilpiea, or m Ur WtA B epees epee not 1. ^ Addfe5e6e'S Addre59 <br />~ 1 <br /> <br />Fr <br />~ e <br />• smut. <br />• Wme Weum Realq Rpt•erd'an tlr menpe0 btow tlr eeicM numhec 2. ^ RaSbfcted D9livery <br />rR j <br />S ` <br />'.' $ •TM Retum Reniq wiG Now to whom tlr snide wee Eaerere0 ens IM tlne s ~ '. <br />' _ <br />>.: <br />~ c delivered. - . CO715UR p051Rt98Ief for fN. ' <br /> <br />~. <br /> <br />::~~'; <br />• <br />0 <br />~ a. nrtlde Addre55ed to: 4a. Arnde NDmber <br />1t j <br />I <br />' <br />~ z a 39 765 o~~f E <br />~ <br /> <br />_ <br />- <br />------ - - ~ - ------ <br />~ <br />. <br />I <br />~ a <br />~ Blake L <br />Mitchell 4b. Service Type ~~ <br />" <br />~ : <br />~ I/' ~ <br />'~'~ ,' <br />-" <br />_ . ^Registered <br />B <br />CertMed ~ <br />~ <br />~ 7763 County Road 38 <br />~7ress Mail ^ Insured <br />^ <br />~ <br />- - - j Mancos, CO 81328 ~ <br />~ <br />If7 McNm Receipt for Merchen6se ^ COD _ - _ - ~ ~ ~ ~ " <br />~ <br />- <br />' <br /> 7. Date of Delivery <br /> _ ~~ <br />e' <br />" e+ <br />- <br /> 5. ReceNed By. (Pdnf Name) 8. Addressee's Address (Only I/reque fed _ <br />~' <br />hFFh~~ _ ~ : ~ _ - <br />' end lee is p9id) ~ ~ ; _ <br />E <br />5 <br />6. SigneNre: (Addressee or Agen) i <br />! <br /> X <br />i ~ , <br />PS Form 871, December 994 <br />10259S97.B-0179 Domestic Retum Receipt <br /> 00362 <br />
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