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2005-09-21_REVISION - M1977493 (3)
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2005-09-21_REVISION - M1977493 (3)
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Entry Properties
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:, COMPLETE THIS 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. Article Addressed. to• <br />��...� <br />/64 /mot- <br />3z(e 7 7 s/ <br />i(d-..z.& /6', [moo r <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />SENDER. COMP <br />OMP.LETETHIS 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. Article Addressed to <br />t $ <br />D' G k -v //" - <br />L <br />go. &K 5 > ? <br />2. Article Number . <br />(ansfer from se <br />Tr vice labe0 s ,j <br />PS Form 3811, February 2004 <br />r <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. icle Addressed to: <br />2. Article Number <br />(Transfer from service label! <br />I PS Form 3811„ February 2004 <br />C:� I 3; L <br />1 1 . oa <br />COMPLETE THIS SECTION ON DELIVERY <br />Domestic Return Receipt <br />B. Received by ( Printed Name) <br />3. Service Type <br />fj Mail <br />❑ Registered <br />❑ Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />7004 0750 0001 7943 4623 <br />A. Signature fin <br />X <br />3. Service Type <br />C2-eertified Mail <br />❑ Registered <br />❑ Insured Mail <br />0 3 <br />4. Restricted Delivery? (Extra Fee) <br />x;700;4; 075Q ;0001 794;3;;4586;; " <br />Domestic Return Receipt <br />C. <br />Q1ji�18�ServiceType <br />Y /6 a erMrtified Mail <br />❑ Registered <br />❑ Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />❑ Agent <br />❑ Addressee <br />C. Date of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />❑ Express Mail <br />Q Return Receipt for Merchandise <br />❑ C.O.D. <br />❑ Yes <br />102595 -02 -M -1541 <br />COMPLETE THIS SECTION ON DELIVERY <br />• <br />❑ Agent <br />❑ Addressee <br />C. Date of Delivery <br />B. R ed by ( Printed Name) <br />D. is delivery address different frommitem -Y ?-.❑ Yes <br />if YES, enter delivery address•below• - <br />❑ Express Mail <br />9-Retum Receipt for Merchandise <br />❑ C.O.D. <br />❑ Yes <br />102595-02 -M -1540 <br />SENDER COMPLETE THIS SECTION <br />st.a ga <br />COMPLETE THIS SECTION ON DELIVERY <br />ei' : -nt <br />7 • le3"s54 <br />Received by (Prin Name) C. 141. of Delivery <br />e. -t; c; aw'T hn 44 q- R-05 <br />`13 Is delivery address different from it 1? ❑ Yes <br />YES, enter delivery address below: ❑ No <br />❑ Express Mail <br />G Receipt for Merchandise <br />❑ C.O.D. <br />❑ Y es <br />' Domestic Return Receipt 102595 - 02 - -1541 <br />
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