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C-1984-067 <br />(Termination of Jurisdiction) <br />SL-1 <br />tak <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 cans to the back of the mailpiece <br />or on the front if space permits. <br />1. Article Addressed to: <br />La Plata County Commissioners <br />County Commissioner <br />1060 E Second Ave <br />Durango, CO 81301 <br />A. Si na re <br />0 <br />X Agent <br />? Addre; <br />B. Received b (Printed Name) C. D rte of Deli <br />N. J. 3; h,(" A q' Z 71n <br />D. Is de ery address different from Rem 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />3. Service Type <br />m r:aWfied Mail 0 Express Mail <br />0 Registered 0 Return Receipt for Merchandise <br />0 Insured Mail 0 C.O.D. <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />(Transfer from service label) r u u r m u c u U U U 1 6 J 40 06 76 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540