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HomeMy WebLinkAbout20040944.tiff (it I DEPARTMENT OF PLANNING SERVICES PHONE (970) 353-6100, EXT.3540 FAX (970)304-6498 O 1555 N. 17TH AVENUE GREELEY, COLORADO 80631 COLORADO December 9, 2003 TO: SURROUNDING PROPERTY/MINERAL OWNERS CASE NUMBER: AmUSR-851 There will be a Public Hearing before the Weld County Planning Commission on Tuesday, February 17,2004, at 1:30 p.m., at the Southwest Weld County Complex, 4209 CR 24 %:, Longmont, Colorado concerning the request of: NAME:Alternative Homes for Youth FOR: Site Specific Development Plan and Special Review Permit for a Child Care Center in the A (Agricultural)Zone District. LEGAL DESCRIPTION: Part of the SE4 of Section 6,T2N, R68W of the 6th P.M.,Weld County, Colorado. LOCATION: North of and adjacent to State Hwy 119; approximately 1 mile east of CR 1. Your property is within five-hundred (500)feet of the property on which this request has been made or you may have an interest in the minerals located under the property. For additional information write or telephone Chris Gathman, Planner. Comments or objections related to the above request should be submitted in writing to the Weld County Department of Planning Services, 1555 N. 17th Avenue, Greeley, Colorado 80631, on or before the date of public hearing. For your convenience, the Department of Planning Services has instituted a Planning Commission Agenda Phone Line. In some circumstances cases need to be continued to a later date. To ensure that this case is being heard, you may call 970-304-6499, up to the day of the scheduled hearing for this information. 2004-0944 SURROUNDING PROPERTY OWNERS AND/OR SUBSURFACE ESTATES/INTEREST OWNER CERTIFICATE OF MAILING AMUSR-851 I hereby certify that I have placed a true and MINERAL OWNERS & LESSEES correct copy of the surrounding property owners and owners and lessees of minerals in accordance BRAGG with the notification requirements of Weld County PO BOX 41 in Case Number AMUSR-851 in the United States NEWELL SD 57760 Mail, postage prepaid First Class Mail by letter as addressed on the attached list this 9`h day of CARRIED GAS VENTURE December , 2003. C/O R HECKENDORF 4085 DEXTER ST ENGLEWOOD CO 80110 CALVIN 733 CHAVEZ RD NW , ALBUQUERQUE NM 87107 Donita Mak WAY 432 MONTANO LN CORRALES NM 87148 HERRING 12222 W NEW MEXICO AVE LAKEWOOD CO 80228 LYETH-BURK PARTNERSHIP 8400 E PRENTICE AVE STE 1005 ENGLEWOOD CO 80111 MACY RESOURCES 650 S CHERRY STE 1400 DENVER CO 80222 HERRING 1630 S IRIS WAY LAKEWOOD CO 80232 TOP OPERATING CO 7500 W MISSISSIPPI AVE STE B-3 LAKEWOOD CO 80226-4541 SURFACE ESTATE LAND OWNERS CONCEPTS DIRECT INC CIO LIFEBRIDGE CHRISTIAN CHURCH 10345 UTE HWY LONGMONT CO 80501 CITY OF LONGMONT 3RD& KIMBARK LONGMONT CO 80501 AFFIDAVIT OF INTERESTED LAND OWNERS Page 1 of 1 AFFIDAVIT OF INTERESTED LAND OWNERS SURFACE ESTATE Subject Parcel: 131306000016 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 from the records of the Weld County Assessor was assembled within thirty days of the application's submission date. 1J C7A Signatu4 II -,qS-oa Date Property Owners Within 500 ft. of Parcel# 131306000016 NAME MAILING ADDRESS PARCEL IDENTIFICATION# C/O LIFEBRIDGE CHRISTIAN CONCEPTS DIRECT INC CHURCH 131306400004 10345 UTE HIGHWAY LONGMONT,CO 80501 LIFEBRIDGE CHRISTIAN 10345 UTE HIGHWAY CHURCH 131306401002 LONGMONT,CO 80501 LIFEBRIDGE CHRISTIAN 10345 UTE HWY CHURCH 131306401003 LONGMONT,CO 80504 LIFEBRIDGE CHRISTIAN 10345 UTE HWY CHURCH 131306400003 LONGMONT,CO 80504 3RD &KIMBARK LONGMONT CITY OF 131307100058 LONGMONT,CO 80501 http://maps.merrick.com/website/weld/setSgl.asp?cmd=buffer&PIN=131306000016&Par... 10/28/2003 ArcIMS Viewer - Page 1 of 1 v • 41 M e t:, I <j ! ` '; I LONGMONT ' --a ',,II . }. e r , z '-'"i'.'3`S, ,tit.)\;� 'yam'y '4vv..,,,,,,"A- 1t t`E+r? �Fz: s:+a ha''u.i." i�w'.��..aY :s -,•`F, . ywcN County CotdsK` 0 �.200ft - http://maps.merrick.com/website/weld/MapFrame.htm 10/28/2003 LIST OF MINERAL OWNERS AND MINERAL LESSEES (Alternative Homes) Subject Property: Township 2 North, Range 68 West, 6th P.M.. Weld County, CO Section 6: That part of the SEA described as follows: Beginning at a point where the North line of the public highway running East and West along the South side of said Section 6 intersects the West bank of the "Julia D. Coffin Lateral," said point being 1242 feet West and 30 feet North of the SE corner of said Section 6, thence going North 208 feet, thence West along a line parallel to the South line, 208 feet; thence South 208 feet to the N. line of said public highway, thence East along the North line of said public highway to the Point of Beginning; EXCEPT portion conveyed to Weld County by Deed recorded 1953 in Book 1355 at Page 409 Minco LLC, an oil and gas title company, states that to the best of its knowledge the following is a true and accurate list of the names and addresses of the mineral owners and mineral leasehold owners having an interest in the Subject Property, based upon the real property records of Weld County, Colorado as same were posted at September 12, 2002. Dated this 13th day of September, 2002. MINCO LLC Byflliam G. Crews, CPL Certified Professional Landman#3477 Mineral Owners Mineral Leasehold Owners: Alternative Homes for Youth Joseph E Bragg Jr 9201 W. 44th Avenue PO Box 41 Wheat Ridge, CO 80033 Newell, SD 57760 Carried Gas Venture %R Heckendorf 4085 S Dexter St Englewood, CO 80110 Mimeo LLC Oil ad gas?itf Services P.O. B 336337 (970)351-0733 Greeley, CO 80633-0606 Page 1 oft Fax(970)351-0867 Mineral Leasehold Owners: (continued) Macy Resources 650 S Cherry, Ste 1400 John R Calvin Denver, CO 80222 733 Chavez Rd NW Albuquerque, NM 87107 James M Martin 943 T Ave Elizabeth Way RR 1, Box 321 432 Montano Ln. Council Grove, KS 66846-8777 Corrales, NM 87148 Murray J Herring Rodney K Herring & Gladsie A Herring & Deborah S Herring 1630 S Iris Way 12222 W New Mexico Ave Lakewood, CO 80232 Lakewood, CO 80228 Top Operating Co Lyeth-Burk Partnership 7500 W Mississippi Ave, Ste B-3 8400 E Prentice Ave, Ste 1005 Lakewood, CO 80226-4541 Englewood, CO 80111 MbwoLLC Oil and gas rtkServices P.O.Bat336337 (970)351-0733 Greeley,CO 80633-0606 Page 2 oft gat(970)351-0867 Weld County Planning Department I GREELEY OFFICE -�� FEB 0 9 2004 � rn RECEIVED 1) ' 1 Alternative Homes for Youth 5 February 2004 Chris Gathman Planner Weld County Department of Planning Services 1555 North 17th Avenue Greeley, CO 80631 RE: SPECIAL REVIEW PERMIT Dear Chris: Enclosed are copies of the Return Receipt Slips for the mailing to the mineral estate owners of the property located at 745 Highway 119 East, Longmont, CO. This mailing notified the owners of the Special Review Permit hearing on Tuesday, February 17th, at 1:30 pm. Of the ten we notified, one had moved and left no forwarding address, and three others, we have yet to hear back from. I've enclosed copies of these—page 3 and page 4 of the attached. Thanks, Chris, for all your help. Look forward to seeing you on the 17th. Sincer , _____40:7 • Jean Osborn Project Coordinator 700 II'esl 84"' .-li enne, Thornton, CO 80260 Phone (303) 940-5540 Fax ( 303) 940-5542 r'` Weld County Planning Department GREELEY OFFICE � JAN 2 0 2004 RECEIVED 11 1 1 Alternative Homes for Youth 12 January 2004 John R. Calvin 733 Chavez Rd NW Albuquerque,NM 87107 RE: 745 Highway 119 E,Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m.,there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4209 CR 24 '/2,Longmont, Colorado. As a mineral leaseholder for this property,you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely, 2a— an Osborn Project Coordinator CC: Chris Gathman, Planner Weld County Planning Commission 700 Nest 84th Avenue, Thornton, CO 80260 Phone (303) 940-5540 Fax (303)940-5542 1) t 1 Alternative Homes for Youth 12 January 2004 Elizabeth Way 432 Montano Lane Corrales,NM 87148 RE: 745 Highway 119 E, Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m.,there will be q hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4209 CR 24 %,Longmont, Colorado. As a mineral leaseholder for this property,you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely, Jean Osborn Project Coordinator CC: Chris Gathman, Planner Weld County Planning Commission .r, 700 Wear 84`"Avenue, Thornton, CO 80260 Phone (303) 940-5540 Fax (303) 940-5542 11 1 I Alternative Homes for Youth 12 January 2004 Rodney K. Herring &Deborah S. Herring 12222 W New Mexico Ave Lakewood, CO 80228 RE: 745 Highway 119 E,Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m.,there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4209 CR 24 %3, Longmont, Colorado. As a mineral leaseholder for this property,you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely, Jean Osborn Project Coordinator CC: Chris Gathman,Planner Weld County Planning Commission 700 West 846 Arenue, Thornton, CO 80260 Phone (303)940-5540 Fax (303) 940-5542 AO C.::-----.........>, I) 1 1 Alternative Homes for Youth 12 January 2004 Lyeth-Burk Partnership 8400 E. Prentice Avenue Suite 1005 Englewood, CO 80111 RE: 745 Highway 119 E, Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m., there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex,4209 CR 24 '/2, Longmont, Colorado. As a mineral leaseholder for this propgrty,you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely, a Jean Osborn Project Coordinator CC: Chris Gathman, Planner Weld County Planning Commission 700 West 84i°Avenue, Thornton, CO 80260 Phone (303) 940-5540 Fax (303) 940-5542 11 1 1 Alternative Homes for Youth 12 January 2004 Macy Resources 650 S Cherry Suite 1400 Denver, CO 80222 RE: 745 Highway 119 E, Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m., there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4209 CR 24%2,Longmont, Colorado. As a mineral leaseholder for this property, you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information, please feel free to call me at 303-940-5540. Sincerely, Jean Osborn Project Coordinator CC: Chris Gathman, Planner Weld County Planning Commission 700 West 84'x'Avenue, Thornton, CO 80260 Phone (303)940-5540 Fax (303) 940-5542 • • $ z 11 1 1 Alternative Homes for Youth 12 January 2004 James M Martin 943 T Avenue RR 1, Box 321 Council Grove, KS 66846-8777 RE: 745 Highway 119 E, Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m.,there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4209 CR 24 %2, Longmont, Colorado. As a mineral leaseholder for this property,you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely, "--)--"ar--- • Jean Osborn Project Coordinator CC: Chris Gathman, Planner Weld County Planning Commission 700 West 84'"Avenue, Thornton, CO 80260 Phone (303)940-5540 Fax (303) 940-5542 • CI111 Alternative Homes for Youth 12 January 2004 Murray J. Herring &Gladsie A. Herring 1630 S. Iris Way Lakewood, CO 80232 RE: 745 Highway 119 E, Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17,2004, at 1:30 p.m., there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4209 CR 24 %4,Longmont, Colorado. As a mineral leaseholder for this property,you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely St-r" Osborn Project Coordinator CC: Chris Gathman,Planner Weld County Planning Commission r 700 West 84th Avenue, Thornton, CO 80260 Phone (303) 940-5540 Fax (303) 940-5542 "-, "....... AO .----- 11"----...........>, flrs rnative Homes for Youth 12 January 2004 Top Operating Company 7500 W Misissippi Ave Suite B-3 Lakewood, CO 80226-4541 RE: 745 Highway 119 E, Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m.,there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent 3 residence mentioned above. The meeting will be held at the Southwest Weld County r Complex, 4209 CR 24 %, Longmont, Colorado. As a mineral leaseholder for this property, you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely, Jean Osborn Project Coordinator CC: Chris Gathman,Planner Weld County Planning Commission 700 West 84`"Avenue, Thornton, CO 80260 Phone (303) 940-5540 Fax (303)940-5542 11 \11 Alternative Homes for Youth 12 January 2004 Carried Gas Venture % R Heckendorf 4085 S. Dexter Street Englewood, CO 80110 RE: 745 Highway 119 E,Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m.,there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent l residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4209 CR 24 'A, Long mont,gmont, Colorado. As a mineral leaseholder for this property,you are being notified(of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincer , Jean Osborn Project Coordinator CC: Chris Gathman, Planner Weld County Planning Commission r'^ 700 West 84i'Avenue, Thornton, CO 80260 Phone (303) 940-5540 Fax (303) 940-5542 11 ' 1 Alternative Homes for Youth 12 January 2004 Joseph E. Bragg, Jr P.O. Box 41 Newell, SD 57760 RE: 745 Highway 119 E, Longmont, Colorado Alternative Homes for Youth Special Use Permit Hearing Dear Mr. Calvin: This is to inform you that on February 17, 2004, at 1:30 p.m.,there will be a hearing with the Weld County Planning Commission for a Special Review Permit for the adolescent residence mentioned above. The meeting will be held at the Southwest Weld County Complex, 4204 CR 24 %3, Longmont, Colorado. As a mineral leaseholder for this property, you are being notified of this hearing in compliance with the state statutes governing a special use permit. Alternative Homes is in the process of acquiring permission to use an existing house on this property for additional residential care services for youths twelve to eighteen years of age. If you have any questions or need additional information,please feel free to call me at 303-940-5540. Sincerely, Jean Osborn Project Coordinator CC: Chris Gathman,Planner Weld County Planning Commission 700 Nest 84"Avenue, Thornton, CO 80260 Phone (303) 940-5540 Fax (303) 940-5542 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY N Complete items 1,2,and 3.Also complete A. Signet fr,.• Item 4 if Restricted Delivery is desired. X �-/ /9, s4 Agent • Print your name and address on the reverse GL4 Iddressee so that we can return the card to you. a_.:. ed by(Printed Name) C. Date of Delivery • Attach this card to the back of the mailpiece, L/ ' 4m4kmd/t/ 1)— - j ' or on the front if space permits. I. Article Addressed to: D. Is delivery address tlttfere��tr+r�ly�A? ' . If YES,enter delivery ;at . 23 q dXe �, r�I ' f. ,(e, �[J'��J 3. rviceiFled Mail • s .- M. 6Q.^ 1.�" *"'' • ❑Registered ■ - - ,-.r Merchandise _; O Insured Mall ❑C.O.D. 7766 4. Restricted Delivery?(Extra Fee) O Yes 2. ArtIde Number (Transfer from service label), 7003 1680 0002 0055 4115 tic Return Receipt t02595A2-M-1540 SENDER: COMPLETE THIS SECTION C•M•!.ETE THIS SECTI•N •N•EL/VE•Y I • Complete items 1,2,and 3.AIM)co plate Ply re 1 item 4 if Restricted Delivery is desirr��dd1t / / O Agent % • ) ■ Print your name and address on the 4evett* JAN ../ , / / 4 a Addressee i so that we can retumlhe card to you. ..,In B�R�N� p;n� 4 • Attach this card to the back of the mailplece�'� received Lby(l d., �� GDeta df- lt ry. 3 or on the front if space permits. A'�/'F u�-'q/9`*+� j�'°�b""a ..,,,, D. Is delivery address different from item 1? O Yes ;! 1. Article Addressed to: i If YES,enter delivery address below: ❑No i j • 4n 722Ga i t • 3. Se 'Type J /. .n - r� ii /1' Y ! s Certified Mall ❑Express Mail �J L I t .) ❑Registered ❑Return Receipt for Merchandise 66:74,g41 J� - ❑Insured Mail O C.O.D. :4,g 41 -a?)7 4. a.;r.acted Denmery?jtxtra Foe) ❑Yes ( ' 2. Article Number llll (Transferfiom:: 7003 1680 0002 0055 4085 orn3811;AugustTh� m ����t��f irrrtrrlrtl ,�{bg�ytnlllrhddminl to ?. 1 i SEN•E': C�M•LETE THIS SECTI•N C.M•LETE TH/S SECTI•N •N •ELIVE•Y i ■ Complete items 1,2,and 3.Also'complete A. Signature item 4 if Restricted Delivery Is desired. A /� O Agent i • Print your name end address on the reverse X O Addressee so that we can return the card to you. II Attach this card to the back of the mailpiece, B.Received by(Printed Name) C. Date of Delivery or on the front if space permits. t 1. Article Addressed to: D. Is delivery address different from item 17 O Yes If YES,enter delivery address below ❑No • 3. Service Type /� oiLI/�p i `""• P-7.0P-7.0 U ❑Certified Mall ❑Express Mall /� i{ ., O Registered ❑Return Receipt for Merchandise �O6/�//�1 'w"'i a4.� .) (.J�r ^X O Insured Mail ❑C.O.D. U 6(�-d..7-- 4. Restricted Delivery?(Extra Fee) ❑ Yes (11) 2. Article Number (Transfer from service label 7003 1680 0002 0055 4078 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ' • Complete items 1,2,and 3.Also complete A Signature Item 4 if Restricted Delivery is desired. X �.y,„=C.. J/� ❑Agent ' i • Print your name and address on the reverse /,((L' Ytf[�i1��`�Addressee ' So that we can return the card to you. a.Received by(Printed Nam C. Date of Deliv ry • Attach this card to the back of the mailpiece, C./---Z�, � er• I •dr on the front if space permits. D. Is delivery address different from item 1? O Yes 1. Article Addressed to: c j - If YES,enter delivery address below: O No " it- I. 62atititai t33 s 1 n .A � 3. ce Type 1 (fled Mall O IExpress Mall �t ���777 O Registered ❑Return Receipt for Merchandise I � 7/O / ❑ Insured Mail ❑C.O.D. I v / 4. Restricted Delivery?(Extra Fee) O Yes i 1 2. Article Number a (Tiansferfrom service label) 7003 1680 0002 0055 4047 "r PS Form 3811,August 2001 Domestic Return Receipt 102595.02-M-1540; I SENSE': C�M•LETE THIS SECTUN C•M•LETE THIS SECTUN •N •ELIVE•Y • Complete items 1,2,and 3.Also complete A Signature I Item 4 if Restricted Delivery Is desired. X\ :1 J _ _ _I 1� ❑Agent I • Print your name and address on the reverse m• C.ld-Ct lSV•�+--S)X O Addressee 1 so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery I • Attach this card to the back of the mailpiece, I or on the front If space permits. D. Is delivery address different from hem 1? ❑Yes ^;. 1. Article Addressed to: If YES,enter delivery address below: O No r'''' i ;zy . OO NC" �v yp Bps r U rl w�,/`N— bled Mall ❑Express Mail , a+,. et) O Registered O Retum Receipt for Merchandise I , UC ❑Insured Mail ❑C.O.D. r ' 80 WI I 4. Restricted Delivery?(Extra Fee) ❑Yes r 12. Article Number I (rransferfrom service label) 7 0 0 3 16 8 0 0 0 0 2 0 0 5 5 40 92 y PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540' 9 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • Complete items 1,2,and 3.Also complete A Signature / Item 4 If Restricted Delivery Is desired. O Agent • Print your name and address on the reverse '� €-f`�i / /llFiii p Addressee • so that we can return the card to you. B. Recalled by(Printed Name) C. Date of Delivery • Attach this card to the back of the mailpiece, ff�� or on the front if space permits. 1W bf A`,7 idF7'JCs'AJ(J1 - 1.7—o D. Is delNery address different from Item 1? ❑Yes 1. Article Addressed to: i._./� If YES•enter delivery O No 151. Zt2 áz ' �� Om .r i I6dQ A. o G CLAfr 3. 's°Type G fike I i Certi led Mel S ' i 4, ) O Registered •- Return R pt for Merchandise i h.C h-LL t'CI w J �^ ❑Insured Mall Q�,, F, �(. 4. nestricted Deuvery?(Extra Fee) 0 Yes • 2. 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