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2009-11-24_REVISION - C1984067
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2009-11-24_REVISION - C1984067
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Entry Properties
Last modified
8/24/2016 3:57:13 PM
Creation date
11/24/2009 10:07:47 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1984067
IBM Index Class Name
REVISION
Doc Date
11/24/2009
Doc Name
Certified Return Receipt (Termination of Jurisdiction)
To
Landowners
Type & Sequence
SL1
Email Name
TAK
Media Type
D
Archive
No
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• Complete items 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 card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Gabriel Ulshafer & Megan Graham <br />2028 Crestview Dr <br />Dural, CO 81301 <br />a si <br />❑ Agent <br />X ❑ Addressee <br />B. Received by (P,lnted Name) C. Date of Delivery <br />D. Is a very�airediff@ rent from item 1? ❑ Yes <br />If YES+: er deliv address belcA ❑ No <br />r °J 9 2M <br />3. Service Ty <br />❑ Certl i Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />— ❑ insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ yes <br />2. Article Number <br />(Transfer from service laben ?005 0 3 9 0 0002 8281 8 4 8 9 <br />Ps Form 3811, February 04 Domestic Return Receipt 102595 -o2 -M -1540 <br />Po stal <br />Er <br />co CERTIFIED <br />MAIL. RECEIPT <br />( <br />m <br />O nly; <br />co <br />OFFICIAL <br />USE I <br />ru <br />co <br />rl.l <br />C <br />Postage: �' <br />$0.44 <br />C3 <br />C3 <br />Certified Fee: r,91,' <br />Fee: <br />$2.80 <br />$2,30 <br />Return Receipt <br />C 3 <br />Er Re <br />M (Enc <br />Total Postage & Fees: <br />$ 5:54 <br />C3 <br />Ln <br />O <br />Gabriel Ulshafer & Megan Graham --------- <br />2028 Crestview Dr <br />--------- <br />Durango, CO 81301 <br />• Complete items 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 card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Gabriel Ulshafer & Megan Graham <br />2028 Crestview Dr <br />Dural, CO 81301 <br />a si <br />❑ Agent <br />X ❑ Addressee <br />B. Received by (P,lnted Name) C. Date of Delivery <br />D. Is a very�airediff@ rent from item 1? ❑ Yes <br />If YES+: er deliv address belcA ❑ No <br />r °J 9 2M <br />3. Service Ty <br />❑ Certl i Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />— ❑ insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ yes <br />2. Article Number <br />(Transfer from service laben ?005 0 3 9 0 0002 8281 8 4 8 9 <br />Ps Form 3811, February 04 Domestic Return Receipt 102595 -o2 -M -1540 <br />
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