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Home My WebLink About20132475.tiffU O co Let 0 a) .5 O U a Q or coca�8 c -0)0n9 c>.C4— OO ce N n o CU a: 2 •C C C U is0 E a' c _a o c c`o O=mQ a) 45 0 3 • %Q a) ^ c •:o a).c0oat_ a) O m -a O w 0 0 a a. 0 _c ° FT, E�c 0 00 co En 0 N a cnEC�0 L O '` .� a) a U if,a) _c>.o.: 77. cU E =� +r a)O0 0c ca -U CO C o r O t .0 a r C 12 a) U (U -C a) co CD a 0 W _ 5 a) QUA 3On co a) 0 CD a) c C C a. c 0 a a) a) L m a) a a) L a) t_ 3 .c aco�-o a) 4' U O U -C L . 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For your convenience, we have posted the agenda on our web page. oio a) O ti J O .00 E en C a' C coa'e'C Cst)o`° co -C C 402' �rti4'o n0CC 0) 41) O CO Cj C v, N Q)) O a) c co > m alb Co X CO CO 1 co o o E etc 2 4' 0 o co 03•a e a O J C• C C b C •t CO c0 cct 713 O j oto fin OoC o — o m J Q -C (n U •0 N O b 0 o C O3 N (0 m CU a 3O 0 o = o n0.C 0 aa))W�E OtcaU in .4_ I CD a) c)b oamb co -co o 3C -S., 15 R3 52 o E co&at. U C ,C c rn) c o C_co a b 0 O C) co o - 'E 0 O L.a)o 03 46.4 o E co •Q ns m LO O 13 (�° a a)E fl. m 02o� I-° ns a) CO Q (n •C 0 0 O (o 0 Z a) .5 O U a Q a Q •E C coP_ a .c c U 3 • C C CO C co cn ° U O cU O C >, 5 (U c c cdU w o c U O U (U *E c aE <0 U 0) C CU C 4- m° L w 0)_c U C 3 -E •S — cU a 2-c C C 0 _m U3 • a 0) U •E o C C m I= — u) 2c L ao -0c c_ aiact co o CD 0 C >, N 4. 3 C aU o cd0 N C o 0 co co To. *E a -on) QU4- O co U) sE a Q 2 c a U 0 cc 0) C co a) a) r C a N L n a) s- o a O U C U) a) :c U 4, CD o a a) V o c7) a) O 0 o ° UC >. O O °a 0 a) C7, a) ° 0 E cfl -� 0 O c o co s-• a a (n a '-Za) CU U a O 0) cm C C O a •c a. 5 a 00 _c a) 8 5 O csii O C U co O L o a -0 'es o ° Ut_ a) c 0 CD 0a) CD TA a) 0 E • (0 — 0 O C o co I- a In asCo c r aoa a) c c 0 sca. .r a a) co .c c 0 w E O co rsc a r CU C E E E n' } • c Ca'Q_a c -Door ` o O U o a)Oc o N a C O U N (U'5 U cU (1) U ` O O o 0 a oD a n a) a :EUa rD > 0• 0 a) co cv U V U c c C (U O cri U C .FT L 0 4- C E 0 L n C U) a) w CU E orat c •- a) .oU.c a 0 .N 0 'c a) a) 0.•-•3 a) 3 o E o >, w CO L T/5 coca? EEr= O O co AD r, o } .c (7 C O �• o t w c0a) O Is 0 stpU .cc a) — N a O E.--) co '> CU 0 0 000o as >ia U co 3 Iv oco .. > 0 a) (U C U c„, -0.-Io O C O O (7 CO C O N O 0 E U co L8ca c U NE a) 3 c O 0 U N tC C - a`�C_E ow 0-3c sa5 .5 w co C — .a To �. > .c 4- ti In In r 8 a a) C •c C cU a O C a) co L N a) O 0 `0 c o co coco CD LC 00 0) T C • 3 E 0 Q s w n In In 8 ,I C c_. C C co a 0 0 C a' co E a a a) t 0 _>,‘ C .a 0 o U c -a o 4-7 CD C CO 00 v) >' lir, CD • c 3 C For your convenience, we have posted the agenda on our web page. For your convenience, we have posted the agenda on our web page. .Qaio O O o°'; -c C 4c:01 C C a7 0) .. •oc 0 co a) Er -•C2 O N j OEco Va)� -U Q. CO O > 4o'� 'E O - 0 c0 C O C Q a) (13 CT) 'f`l bo co �CC ill N 0 co 3 big QED O. C L iz ccO o co zas cc cn C U a) .o co co co m C co C ,o co U C C co a m w 0 0 .a ca 0 • 2 o l ti o) a) •C ki co c 0 CO E) n0c co E U 0 a 0 CO C co C .2 h E U •c c m w w O .Q m O E U, a) U a O O a) to c r ('r) C co • C co x CL Q 0D O O O D U Co o r >,M UZ a)M ��00 Ls-)Orn Case #: USR13-0037 c E E c 0 as a s r O cp Q) CC co — ..0 U r (13 O 45 0 .(76r J (6 CO O C 3 C O r• r C N (0 U.- 0 J L_ . 03 r N •:1-- o O4U ft O d U co n) 0 c O c N tin 'O 0 U c co — E c a) a) Es L Q w > C o a) 0 .. ca W 0 0 0 0 0 L .O N Cd C� CC a) O c6 0 .� D c c°- �� Co co a) -o 5 ..�cU c aa, _ Co L.: L r Y u) c o ,_ ) ca ai 0 O+-' 0 c U E a a) v c= U ca°ooa)r°UO za5J 3aam a) U_ z a) (/) 0) C_ c C`') c CO co a) o 7- >00 Q O c O c c� O r >,c U Z a) ?LeS O Li)CDrn NI Y •' a a l Case #: USR13-0037 0) a) a) J C C J 0 U a) a) C C a) E co z 0 a a) D L Ca CO O— CC L- W D . C) U O O N CB a D c 0 CO a co oa) a -C co E r O O CC O r U r CO.-' o co CO O CD r r N O r 0 - CD r N V CC O Q cU cN a) CO (n Co E C .. C L Q r U Cr Op r as a) O — C (/) t cn �- C c �i C •a O c 2 U V c U 0o OO .J CL CL P. I 5 a) U a a) () 0) C C C ca a) (l >> - L c -- cr o r U Z -0to (3.)� �Lc) r O r CO CO �; O X CO O O0 UQO �C15 (1) LO -(1-)C CD OC Case #: USR13-0037 C o co O)a -o O J Co .... c 3 C c 0 J L co O U T U c L D O W U O o L .� N L.. .. — C CC) LO o ca D) o cin C ` O E a. as U 0 0 0 z a - 1 CC r U .42 a) U Co -o Ca c Ca 4- 0 U, a) Planner: Chris Gathman Ecs 0 r Co CO O N a CU O CO r Co C`7 r O N O N O a°' W a Ca a) c c c a) FF.: = 0U O CLm a) U a a) (/) C3) C C C co a) [1 > -r c c� O r U Z -0 cr) cp i a a O t7' LU rC"i Co Co.-; O X O O co O0 C.) co >, a) in O 0O CD a) Case #: USR13-0037 c O o a r cr C O _O O U a) a) J Ca - C 3 C C CO a J CO O V Co in "O C O Cv 4_ W O O O .^ N L ..- — c O O c a j U) a) 'a 5 . Cv 0 .` ai O cr... E Q -Co �°a)o z a L r r U O C a) U Ca Ca C CO 4— O U, a) Planner: Chris Gathman a0 O O r Co O M r N O - N O a Q) U) C Q 4' 0 ca a) c c a) i 0 UO am I SURROUNDING PROPERTY OWNERS USR13-0037 In M N M Ni Ln N O 00 O CO N d i.11 N O r1 O t — O N O N vH N 00 CO CO 00 CO CO w F- < H v) H U N in w CC 0 0 w 2 Q Z FT COLLINS CO 608 E HARMONY RD STE 203 BCK HEATH PROPERTY LLC DENVER CO 600 GRANT ST STE 640 STATE OF COLORADO PINEBLUFF WY 53863 CR 136 FREDRICK FANGMEIER O U CC LU ›- CO 2360 S QUAIL HOLLOW RD U Z cc (..9 PINE BLUFFS WY 68810 CR 111 GLEN KLAWONN OLATHE CO 3015 61.25 RD NOEL'S GRASSLANDS RANCH LLC 82053-9799 BURNS WY 1150 RD 153 KENNETH ROHWEDER 80215-7210 LAKEWOOD CO 2850 YOUNGFIELD ST Q v) D O ri 00 AURORA CO 1398 CLINTON LOYD WALTERS CERTIFICATE OF MAILING I hereby certify that I have placed a true and correct copy of the surrounding property owners in accordance with the notification 1/1 CD L_ CU -4-. a) >- ru 2 (0 U V) LL ro a) L a a) OA ra 4-1 V) 0 a ro 2 tn (/) D (1) • C D (1) 4-1 addressed on the attached list this 23rd day of July, 2013. M ri O N >- D Dated the 23rd day of E C) in O Co Cr O C) ' c }, M V' N i > O M 73 N * C) O in >' O N (13 4--0 QJ O1 (13 — 0 0 Kristine Ranslem Recording Secretary for Planning Commission Application Review Notification Card U 0 CO .tea O a) a) CC 0 co a This is to notify you that the project listed on the This is to notify you that the project listed on the Cll C U) T2 co 45 U) L a) 4.O (500) feet of your property. You will be notified Q) a) L C C a) c � 0 a co U OL U) a o O 4 O O CC a) .En a) C O L O of any future meetings regarding the proposed of any future meetings regarding the proposed a) C O C _ — -c c C u) c a-- U) C �+j Co CD a).C U� co 9 t D Lr C a) u) o0 O .o .C N c — O (� >, a) O LCo_o' a OO t �O CO CDr U) cep .C co O V O U c) -)O (D U >, C n A a) C� >, 00 L Dca3CL CO L E oa CO aN oU 2 co.0 o c a a)CL_ cv. �oU >, (n C Ls= C O 0 O O rST C N+-�.:::,O E tj L6 a)O O — Q) o O E D U) O Q o .C 000c L Off}' U a) cn it UE. a3 o z a)r > o cb in -O s L U • -• o, U)O COID O C _ no cn 0 c .n all 4-,U_ O C CD C cah) (n O > . r Co a) Q) `- O CB CD O - U) project on this property. 0) CD C o 0 C -0 0 0).� co CO a N iN _=, cl- (wn C a) 0 o 0 O .O .c '- C aC>,oel) L C 0 -c t a o > O n .4EO E U) W co U O CCD C� U CO U a >% aC6 >, CO 701- o_= Ea3 (pcN O 0). D ;•�-, C OD a a) a)}115 t oD_a C`+= D000 O 0 •_ O O > N co - • U °ow° L O O a) O n O O ) cO a) _c O (n E c ~ Ecg�E'Lr a)E->coz �, U c K o 1 C" L LO - _� Lo U a) 73 LO O C E .- (u � C � U) O_ C -Q w ET — O C U >, C CD C U) U) a 0 `- 0 a5(LS 0 _0 CD ication Review Notification Card a Q Review Notification Card O co a Q This is to notify you that the project listed on the This is to notify you that the project listed on the f Cll th T C U) CD other side of this five -hundred C U) T2 co 13 a) O CD (500) feet of your property. You wil will be notified of any future meetings regarding the proposed a) O O L a) C) 5- L C � o a) W O .� C) CC C C U Q) C -C O — O aii 114 O C O o _ — -c C U) C a--' U) C -0 0 a -, co c�� -' .�� CO 4L C a- C C a) 0 O .O -.c Q) C a CO O E >") O O w O cco U) ._ U) O'er o ca 8 a) p o >, C n >, co C6 >, co i -0 C N Q) C O o L aE N oU a c� _ O o �'0 =a Cv��.0 >, O Q) C co }'CD TI5 CD U o 0 L O O '- I o o a) o t a) o ._o°QC L 4) f ' O o 0) CD a L -(- E o `i3 o z o E.5cb U to L o —.c�o n -o L U a) In -5 u -)O c co� —.ui DE :4=E g 1 ); a3 • C O •- Q) 1+- CD CD O _0 CO CD a) C O CO C r -C C C U) C +-.U) C - O cm .-- (B CO CC -0 a) . * = 1 C o W C O O .0r.c°'C o (t>,00 LEO_O�E O >O CD O Qr 1 U) a) C° o To U O C) t -0 c cv c 2 CO a co N O L a F.: C U) 0 U a >o 1.oU >, (n C `- . C) T.)O Oco c6 .«-. . — C O 0 tie; O C) O _ Q) O C C O Q •- O 0 O C 2 Q) c - R- a) 0) _c a o ca E D +-' U E .c r a) co �^,, o z •� ^ C.) (� L WC LO to -c_3)) Q) CD in O C 0 g :4--' U) o `", o C O C (D r- U) Q) `!- or)) U) ike m CO a) c.) a) a)i c r M c co co > u o a 0 c Ow o >.M UZ M N to 92 o 00a) 1 N a) C.) .E. O O a) 3 c r M c co s_3 > a) a Q O c O CO o r >,M 0 QM � to 20 ?moo C co 122 fl. r n -a J 0 co C 3 C c a) n to O r ►a co r U Lce U c jv13 2E O > C O C c0 LV t O Cn r• - .-% ▪ (6 � LO 115 ° To D�U -o C.) N0�CI) vi E Cla g C c co co 0 O a) co ozaw_i 3a 6 0 U Z a) 0 a) C r N CD O > o co E Q a >, O O o r >ten 0z oM O LO �o N- M O O Cl) r D 0 a, co U c a a -o0 U J' O 4 -co ... c 3 C C J a) L Co O ,— U cj vv O fo wj g O L o N -C C45 2 Co O CaO� o — Y • 0 O E�coC as°0O za-� r r U 0 C 8 Lerr co c co w 0 4- 0 3 c .cc fo U) U a) co c a i A 6 U) a) U a o O a) C r M • C CO( Las < >...c O a o r >. C'`) 0 2 tO Cfl M 0 o. .n' V a) o co .� c 3 c C a) r J (o o r �- O (o 1 NN O L Co 0c C • D 'a Co o ▪ ° M W V O L L 0 O 4— d osal °o co�c c ccoocoo°oaa)co ozaE_i 3a I •• r G a C Co M a) o. D .a J c c J 0 ' O o O > W CC M c Y cu co cu oz o cc t N O 3 c co '.- Cl) _'a ce i fo D: (o c• O O a) N -C ajU) • c a. co cu 0 0 0 4- r v- 0 C Co V c co 9- O C Co L fo U) L O C c 2 a •,. VJ SURROUNDING PROPERTY OWNERS USR13-0037 In M N M Ni IJl N O 00 O CO N d Ln N O r1 O t O O N O N vH N 00 CO CO 00 CO CO w F- < th H U V) in w CC 0 Q w 2 z FT COLLINS CO 608 E HARMONY RD STE 203 BCK HEATH PROPERTY LLC DENVER CO 600 GRANT ST STE 640 STATE OF COLORADO PINEBLUFF WY 53863 CR 136 FREDRICK FANGMEIER O U CC LU ›- CO 2360 S QUAIL HOLLOW RD PINE BLUFFS WY 68810 CR 111 GLEN KLAWONN OLATHE CO 3015 61.25 RD NOEL'S GRASSLANDS RANCH LLC 82053-9799 BURNS WY 1150 RD 153 KENNETH ROHWEDER 80215-7210 LAKEWOOD CO 2850 YOUNGFIELD ST Q D O ri 00 AURORA CO 1398 CLINTON LOYD WALTERS CERTIFICATE OF MAILING I hereby certify that I have placed a true and correct copy of the surrounding property owners in accordance with the notification cc a) 4-) 4-a) >- ru 2 (0 U V) ii ro a) L a a) OA ra 4-0 V) a • n3 2 a) +-, ro +-0 D a) C D CU • 4-1 n 0 O c D a) E D Z v r0 U C c c 0 U (r O v) a-+ c a E a) L D v i USR13-0037 addressed on the attached list this 13th day of June, 2013. Dated the 13th day of June. 2013 E a) VI C ft CCr � a) C V1 -o a) C 2 . N ro . cs1 0 O C _ O N O (Si r M r M r N 4-1 E a) tn co CC a) C Y Recording Secretary for Planning Commission WELD COUNTY COLORADO LAND RECORDS AFFIDAVIT OF INTERESTED LAND OWNERS SURFACE ESTATE THE UNDERSIGNED, States that to the best of his or her knowledge the attached list is a true and accurate list of the names, addresses, and the corresponding Parcel Identification Number assigned by the Weld County Assessor of the owners of the property (the surface estate) within 500 feet of the property being considered. This list was compiled utilizing the records of the Weld County Assessor available on the Weld County Internet Mapping site, http://www.co.weld.co.us, and has not been modified from the original. The list compiled for the records of the Weld County Assessor was assembled within thirty days of the applications submission date. Signature Date Property Owners Within 500 ft. of Parcel # 003531000003 Account Parcel Owner Mailing Address R0016486 003529000007 BCK HEATH PROPERTY LLC 608 E HARMONY ROAD STE 203 FORT COLLINS CO 80525 R0022586 003736000004 COLORADO STATE OF 600 GRANT ST STE 640 DENVER CO 80203 R0017286 003531000003 EVERITT KENNETH H 45571 CR 118 GROVER CO 80729 R0020286 003725000006 FANGMEIER FREDRICK V 53863 CR 136 PINEBLUFF WY 82082 R0020186 003725000006 FANGMEIER FREDRICK V 53863 CR 136 PINEBLUFF WY 82082 R0020286 003725000006 FANGMEIER LINDA A R0020186 003725000006 FANGMEIER LINDA A R0016586 003530000002 GMR INC 2360 S QUAIL HOLLOW RD BYERS CO 80103 R0017486 003532000005 KLAWONN GLEN 68810 CR 111 PINE BLUFFS WY 82082 R0017486 003532000005 KLAWONN JILL R0017386 003532000004 NOEL'S GRASSLANDS RANCH LLC 3015 61.25 ROAD OLATHE CO 81425 R5384908 003530100019 ROHWEDER KENNETH 1150 ROAD 153 BURNS WY 82053-9799 R5384908 003530100019 ROHWEDER LALANI R0265387 003530100019 RURAL ELECTRIC ASSN INC STATE ASSESSED R0134186 021501000008 U S A 2850 YOUNGFIELD ST LAKEWOOD CO 802157210 R0144586 021706000001 U S A 2850 YOUNGFIELD ST LAKEWOOD CO 802157210 R0144486 021705000008 WALTERS LOYD I 1398 CLINTON AURORA CO 80010 July 17, 2013 To: Chris Gatham cc: Kenny Everitt Subject: USR 13-0037 Chris: Attached are the pertinent materials regarding Mineral Notice. Notices were sent on July 17, 2013 via Certified US Mail to: Diversified Operating Corporation 15000 West 6th Avenue, Suite 102 Golden, CO 80401 GTS Energy Consulting 8644 East 29th Place Denver, CO 80238 Mr. Larry Enderson 101 Turk Avenue Cheyenne, WY 82007-2518 Foundation Energy 1801 Broadway, Suite 408 Denver, CO 80202 Thanks!! Linn i • CERTIFICATION RE: NOTIFICATION OF MINERAL INTEREST OWNERS AND LESSEES The undersigned Applicant certifies compliance with the provisions of C.R.S. § 24-65.5- 103(1), and in support thereof, states and certifies as follows: 1. That Applicant has provided notice, (a copy of which is attached hereto as Exhibit "A"), containing the time and place of the initial public hearing on its application for Case Number L/SA13 --o 6 3 7 , the nature of the initial public hearing, the legal description by section, township and range of the property which is the subject of the initial public hearing, and the name of the applicant; 2. That said notice was provided thirty (30) days prior to the scheduled public hearing, that it was provided by certified mail, return receipt requested, or by a nationally recognized overnight courier; 3. That said Exhibit A includes the list of the names and addresses of the surface owners, mineral estate owners and lessees of mineral interests to whom the notice was sent, including those persons who have requested receipt of such notices, pursuant to C.R.S. § 24-65.5-103(3). APPLICANT: STATE OF 0 Dr(D COUNTY OF ytuy,,,... mop, c�ibe o f fort.re me thisda of V i 200 t� Y by Ashley T Fischbach NOTARY PUBLIC 1 kfrta. STATE OF COLORADO Not Pub NOTARY ID 20094021415 ES0L012J1 c21)-17. Nate: 1MYSCe ? giPmoSt�tie Mired h the Wed County Department of Planning Services prior to or at the initial public hearing. If the Certification is not received by that time, the hearing will be rescheduled to a later date, and Applicant must re -notify all owners of mineral interests. G;nfl T, 44-4-eLar / (Lrr e el SSoc/iifS LEEBURG & ASSOCIATES 707 Hawthorn Avenue 0 Suite 207 0 Boulder, CO 80304 0 (303) 442-2428 July 17, 2013 Diversified Operating Corporation 15000 West 6th Avenue, Suite 102 Golden, CO 80401 To Whom It May Concern: As a possible Mineral Interest Owner and/or lessee in the E1/2, SE 1/4, Section 31, Township 12N, Range 59 West of the 6th P.M., County of Weld, Colorado, please be notified of a pending Use by Special Review (USR) Application within Weld County. Said proceeding known as USR 13-0037 is tendered by Kenneth H. Everitt for a "Water Depot" on Parcel No. 003531000003 (proposed USE attached along with a map). The Weld County Planning Commission will address this Application on August 20, 2013 at 1:30 p.m. at 1150 'O' Street, Greeley, Colorado. Should you have questions, kindly call me at 303-947-0791. Sincerely, Linn T. Leeburg Everitt Water Depot (Enderson Site) NW Corner CR-111/134 Hereford, CO 80732 Parcel # Project Overview Proposed USE of the Property Mr. Kenneth H. Everitt owns the aforesaid parcel. The parcel is the East 1/2, SE 1/4, Section 31, T12N, R59W east of Hereford, Colorado. His intention is to build a Water Depot for oil field services of some 2± acres on the 80 -acre parcel via a Use by Special Review (USR) Proceeding within Weld County. Water will be supplied via a commercial well to up to 20-20,000 gallon portable water tanks with appropriate manifolding. A maximum of 200 truck loads per day would be anticipated. No permanent employees will be on Site with truck drivers being there during loading operations for less than 30 minutes. Hours of operation will be 24/7/365. Portable toilets are requested, as well as a trash dumpster. No domestic water source is proposed. No storage of equipment will be required with farmed lands, fallow lands and natural grasses elsewhere on the parcel. Truck tankers of up to 85,000 gross vehicle weight (gvw) will access the Site via gravel CR-i 11 and CR-134 with traffic thence disbursing equa ly north, south and east from the CR-111/134 intersection thence further disbursing largely equally to other roads in the area depending on oil field customers' needs. Revised May 17, 2013 OOVNOl00 'AlNf100 013M 1S3M 6S 3DNY8 'Hl2iON Z L dIHSNM01 'LS NOI133S NV1d 1N3rvd013A30 313103dS 311S US11 11Id3A3 ANN3N XXX asn 10d30 b31YM 11143//3 DRAWING INFO. oT tam o VI i I 7 1 pouscara in I LW I An arty-cit. 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No.; or PO Box No. City, St& /- 4 Pte; A "t- a:k ^6 ✓/1 0 '•"--S - 29.9% l • .-, dpi" g D n 3 PS Form 3800, August 2006 40, See Reverse for Instructions ru 0 9- D D D Cl D r9 0 rR r r -t O N 91469 0130 C O D O r -R D rR O U.S. Postal Service TEA CERTIFIED MAILIM RECEIPT (Domestic Mall Only; No Insurance Coverage Provided) r delivery Information visit our website at www.usps.come Postage Certified Foe Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Postage & Fees Sent To Fh a/c'rSO /) -Street. Apt. No.; or PO Box No. City, Star Y Pt4 eaD/rA PS Form 3800, August 2006 2-s/11 See See Reverse for tpstructfons U.S. Postal Service TM CERTIFIED MAIL RECEIPT (Domestic Mall Only; No insurance Coverage Provided) ,'. 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ZIP -4-4‘ O O Gvo Z "file/ Mee / °1 4'%or 8o ye PS Form 3800, August 2006 See Reverse for instructions 101a 0000 ru O U.S. Postal Serviceim CERTIFIED MAIL,., RECEIPT (Domestic Mall Only; No Insurance Coverage Provided) For delivery Information visit our website at www.usps.comr, Postage Certified Fee Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees Sent To City, State P+4 PS Form 3B00, August 2006 4co _ U CO (-C asvi See Reverse for Instructions U.S. Postal Service CERTIFIED MAILS.., RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) Postage Certified Fee Return Receipt Fee (Endorsement Required) Restricted Deliver/ Fee (Endorsement Required) Total Postage & Fees f1J Sent To OS`treot. Apt. . [ti tor PO Box No. City. Slat IP+. Sv rPS Foc00, August 2006 0 O a ru rR O enn 3 A 3 ark e 41. r See Reverse for Instructions U.S. Postal Service nt CERTIFIED MAIL. RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) Postage Certified Fee Return Receipt Fee ,,Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage & Fees Sant To Street, Apr. No.; /� scog or PO Box No. eeQ 1 /.5rea 44.1e / �7e / City, State. ZIP+4 I `� I�t% act, tee. 8o a L PS Form 3800, August 2006 See Reverse for Instructions_ USPS.com® - Track & Confirm Page 1 of 2 English Customer Service USPS Mobile USPS.COM' Quick Tools Track & Confirm Ship a Package Send Mail Manage Your Mail null Find USPS Locations Buy tamps cac t'aCk & Confirm Find a ZIP Coder" Hold Mai' Change of Address GET EMAIL UPDATES Find T,fa AILS YOUR LABEL NUMBER SERVICE STATUS OF YOUR ITEM DATE & TIME L 70121010000094690130 First -Class Mail' Delivered July 24, 2013, 12:11 pm I Check on Another Item What's your label (or receipt) number? 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