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2013-09-03_REVISION - M2005044
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2013-09-03_REVISION - M2005044
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Entry Properties
Last modified
6/15/2021 6:00:15 PM
Creation date
9/5/2013 9:48:10 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2005044
IBM Index Class Name
REVISION
Doc Date
9/3/2013
Doc Name
Conversion Application
From
Lincoln County
To
DRMS
Type & Sequence
CN1
Media Type
D
Archive
No
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• Complete Items '{;,2, and 3. Also complete A. Signature I <br />Item 4 if Restricted Delivery Is desired. r Agent I <br />• Print your name and address on the reverse ❑ Addressee - s ► . <br />so that we can return the card to you. �eceived by (Printed Name) C. Date of Delivery <br />• Attach this card to the back of the mailplece, <br />or on the front if space permits. `w 1C e �' 5 r, 'S I I • • • <br />D. Is delivery address different from Item 1? 0 Yes C3 <br />1, Article Addressed to: r If YES, enter delivery address below: P—No 0 <br />C3 <br />r%- Postage $ <br />fU Certified Fee <br />/ 3, SSer oe Type I C3 Return Receipt Fee <br />M3 Certified Mall ❑ Express Mall i O (Endorsement Required) <br />';{ ( ❑ Registered ❑ Return Receipt for Merchandise Restricted Delivery Fee <br />13 Insured Mall E3 C.O.D. 0 (Endorsement Required) <br />4. Restricted Delivery? (Extra Fee) ❑ Yes r1J Total Postage & Fees $ <br />ru <br />2. Article Number I <br />7012 2218 0002 5703 4004 <br />(transfer from service fteq _ _ _ __ I N <br />T <br />►3 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595.02 -M -1640 I C3 <br />I <br />COMPLETE • N COMPLETE THIS SECTION ON DELIVERY <br />• Complete items 1, 2, and 3. Also complete A. Signature i I <br />Item 4 if Restricted Delivery is desired. Agent I <br />• Print your name and address on the reverse X ❑ Addressee , <br />so that we can return the card to you. B. Received by (Pr/ d Name) C. Date of Delivery I '� <br />■ Attach this card to the back of the mailpfece, 'ter t' .( �� C3 <br />or on the front if space permits. <br />D. Is delivery address different from Item 1 Yes I M <br />1. Article Addressed to: <br />/ If YES, enter delivery address below: AS0 ( C3 N Postage $ <br />Ln <br />Certified Fee <br />yn; � nj <br />{ ( C3 Return Receipt Fee <br />CCU (Endorsement Required) <br />3. Service Type Restricted Delivery Fee <br />I C3 (Endorsement Required) <br />Mcertified Mall ❑ Express Mail I r-1 <br />❑ Registered ❑ Return Receipt for Merchandise I rU Total Postage & Fees $ nj <br />❑ Insured Mail ❑ C.O.D. I <br />Sent To % <br />4. Restricted Delivery? (Extra Fee) ❑ Yes i ru ��� <br />a l� _-_ _A. -. f <br />2. Article Number 7 012 2 212 0002 5 7 0 3 4 011 I C3 Street --- . No.; <br />(rransferfrom service laben _– T - - -. -- .- -.____ _ I City Stare, ziP +4 - <br />'S Form 3811, February 2004 Domestic Return Receipt 102595.02 -M -1540 <br />y 1, -Qp, . <br />3' / Postmark # <br />5 <br />lz <br />kl <br />'qv��/ <br />
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