RECEIVED
    CLERK’S OFFICE
    APR 25
    2005
    STATE OF ILLINOIS
    Pollution Control Board
    SENDER:
    COMPLETE THIS SECTION
    COMPLETE THIS SECTION ON
    DELIVERY
    •
    Complete items 1, 2,
    and 3. Also complete
    it~~4
    if Restricted Delivery is desired.
    a
    Print your name and address on the reverse
    so that we can
    return the card to you.
    N
    Attach this card to the back of the
    mailpiece,
    or on the front if space permits.
    1.
    Article Addressed to:
    4
    /
    7
    /
    05
    B
    M.
    PC~1..2005—177
    Nanèy Dotterer
    22~8 E.
    240 North Road
    Fairbury, IL 61739
    /
    A
    Signature
    ~
    ~
    ‘Received
    by
    (
    Printed
    Name)
    C.
    Date~
    DeI~ve
    ~
    D.
    Isdelivery address different fromltem 1?
    (0
    Yk
    if YES, enter delivery
    address below:
    0
    No
    3.
    S~yice
    Type
    ,.~..Pertifled
    Mail
    o
    Registered
    0
    Express
    Mail
    0
    Return Receipt for Merchandise
    o
    Insured Mail
    0
    C.O.D.
    4;
    Restricted
    Delivery?
    (Extra
    Fee)
    0
    Yes
    2.
    Article Number
    (Transferfrom seniice
    label)
    7004 2890 0004 2~964687
    o
    A$ent
    ~‘Addressee
    PS
    Form
    3811,
    February
    2004
    Domestic Return Receipt
    102595-02-M-1540

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