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2005-09-21_REVISION - M1977493 (3)
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2005-09-21_REVISION - M1977493 (3)
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Last modified
6/15/2021 5:45:55 PM
Creation date
11/1/2011 7:29:06 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977493
IBM Index Class Name
REVISION
Doc Date
9/21/2005
Doc Name
Documentation of Notices to Parties within 200'
From
Climax
To
DMG
Type & Sequence
AM5
Media Type
D
Archive
No
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SENDER: COMPLETETH!S SECTION <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. <br />Article Addressed to: <br />L Lyra a'd f�u5 <br />i / LC�z 2ri chi 5Iz'� <br />cY6 <br />1 2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <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 />II Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />, at-t 07-id 1/5 -Cyr <br />p, 4 ( 71z <br />2. Article Number <br />(Transfer from service label) <br />PS'Form 3811, February 2004 <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 />4'1 qvg <br />Domestic Return Receipt <br />-7004 0750 <br />Domestic Return Receipt <br />7004 <br />Ilnrnactirs Rgtnn, Rgngrnt <br />COMPLETE THIS SECTION ON DELIVERY' <br />B. W rued by! Printed Name) <br />D. Is delivery address different from item 1? ❑. Yes <br />If YES, enter delivery address below: ❑ No <br />J <br />3. Service Type <br />[2'e 'died Mail <br />❑ Registered <br />❑ Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />❑ Express Mail <br />0 Receipt for Merchandil <br />❑ C.O.D. <br />7004 0750 0001 7943 4609 <br />,41'VL <br />r b � <br />0 Agent <br />❑ Address <br />C. Date of'Delive <br />!�� r•Q�Z <br />❑ Yes <br />102595 02 -M - 15 <br />SENDER: COMPLETE THIS SECTION <br />COMPLETE THIS SECTION ON DELIVERY <br />4 <br />A. Signs <br />D. Is <br />If <br />r <br />, C. ate of'Delive <br />U e a r e s s d' _ _ • m item 1 ? ❑ Yes <br />deliv below: ❑ No <br />ed by <br />❑ Agent <br />❑ Address( <br />3. Service Type <br />C3 eertifed Mail ❑ Express Mail <br />0 Registered EiFr`fe m Receipt for Merchandil <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) <br />0001 7943 4630' <br />3i" 1!d d'. ki ix„� rt,'.'r° 7 .• Y4 t <br />SENDER:, COMPLETE THIS SECTION <br />;COMPLETE THIS SECTION ON DELIVERY <br />A. Signature' " <br />X C <br />B. Received by ( Printed Name) <br />l ate of Deliver <br />11► Iti1 <br />D. Is delivery address different • m item 1 ` A Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />13 t fled Mail <br />❑ Registered <br />❑ Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />2. Article Number <br />(Transfer from service label) <br />/1/. <br />DC Ce.rm .`S 1 1 ❑oi.r, mn, 9nna <br />0750' 0001 7943 4678 <br />❑ Yes <br />102595- 02 -M -1'. <br />❑ Agent <br />❑ AddressE <br />❑ Express Mail <br />e um Receipt for Merchandi: <br />❑ C.O.D. <br />❑ Yes <br />1n95AF- 09 -M -15 <br />
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