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C-1981-042 <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 />A. Signature <br />? Agent <br />X ? Addressee <br />B. Received by tinted Name C. Date of livery <br />7 <br />a ors 7 12 <br />2 <br />D. Is delive address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />1060 E Second Ave 3. s Ice Type <br />Durango, CO 81301 Certified 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 7007 3020 8001 6340 8683 <br />(Transfer from service labeO <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540