ORI6~N4L

RECEIVED

CLERK’S OFFICE

NOV

2

a

2005

STATE OF ILLINOIS

Pollution

Control Board

SENDER:

COMPLETE

THIS SECTION

•

Complete

items

1,

2,

and

3.

Also

complete

item

4

1

Restricted

Delivery

is desired.

•

Print your

name and

address

on the

reverse

so that we can

return

the card to

you.

•

Attach

this card

to the back

ot the

mailpiece,

or on

the tront

if space permits.

1.

ArticleAddressed to:

11/3/05

B.M.

PCB 2005—215

James

E.

Stevens

COMPLETETHIS SECTION ON bELlVERY

A.

Received by (P/ease

Print C/early)

B,

Dthte of/3eliverY

C

S

n

ture

4~deliv

E

Agent

C

Addressee

a

dress different from

item

1?

C Yes

If YES.

enter

delivery address below:

0

No

Barrick, Switzer,

Long, Baisley

2.

/

701

~

~

‘..—‘.‘ -‘.—...

--

&

Van Evera

One Madison Street.

Rockford,

IL 61104

3.

Service Type

1~ertifiedMail

C

Registered

C

Insured Mail

C

Express Mail

o

Return

Receipt br

Merchandise

o

COD.

4.

Restricted

Delivery?

(Extra Fee)

C

Yes

102595.99.M.1759