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2012-09-21_REVISION - M2007006
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2012-09-21_REVISION - M2007006
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Entry Properties
Last modified
8/24/2016 5:08:35 PM
Creation date
10/18/2012 8:56:38 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2007006
IBM Index Class Name
REVISION
Doc Date
9/21/2012
Doc Name
CERT. MAIL RECEIPT - CS CANCELLATION NOTICE
From
FREMONT PAVING & REDI-MIX
To
DRMS
Media Type
D
Archive
No
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cJI/ <br />a- <br />0 <br />$0.45 <br />$2.95 <br />$2.35 <br />/0 <br />U.S. Postal Service,. <br />CERTIFIED MAILTM RECEIPT <br />(Domestic Mail Only; No Insurance Coverage Provided) <br />Ret, Total Postage & Fees: <br />(Endorse <br />Restricted Delivery Fee <br />(Endorsement Required) <br />Total Postage & Fees <br />San Mr. John P. Ary <br />Fremont Paving & Redi -Mix Inc <br />839 Mackenzie Ave <br />P 0 Box 1720 <br />Canon City, CO 81215 <br />Stre <br />or F <br />Postage: <br />Certified Fee: <br />Return Receipt Fee: <br />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 />Mr. John P. Ary <br />Fremont Paving & Redi -Mix Inc <br />839 Mackenzie Ave <br />P 0 Box-4720 <br />Canon City, CO 81215 <br />PS Form 3811, February 2004 <br />Domestic Return Receipt <br />A. Signatu <br />X l,( <br />❑ Agent <br />❑ Addressee <br />Regelved by ( Pdatpd Name) C, Date of Deliv ry <br />)Cq `- a 6 1 - 2I -/ <br />D. Is delivery address different from Item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />❑ Certified Mail <br />❑ Registered <br />❑ Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />2. Article Number <br />(transfer from service label) 7011 3500 0002 960? 8609 <br />❑ Express Mail <br />❑ Retum Receipt for Merchandise <br />❑ C.O.D. <br />❑ Yes <br />102595 -02 -M -1540 <br />
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