RECE~VED

~~1ALI

CLERK’S

APR 202005

OFFICE

STATE OF ILLINOIS

Pollution Control Board

SENDER:

COMPLETE THIS SECTION

• Complete items 1, 2, and 3. Also complete

item 4 if 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 of the mailpiece,

1.

ArtioleAddressed

or on the front if

to:

space

4

permits.

/

7

/

05

B .

N.

/

PCB 2005—175

Jan Hueber

20788 Heal Road

Creston, IL 60113

~

A. Sig

~

ure

/~ddressee

B. RrbY(7~fedNarne

~C.~,zfDe7eg~

D. Is delivery address different m item 1?

Yes

If YES, enter delivery addr~ssbelow:

0 No

3~S~viceType

~.Certifjed Mall

0 Express Mail

t~Registered

£1

Return Receipt for Mérthandise

0 Insured Mail

0 C.O.D.

4. Restricted Delivery?

(Extra

Fee)

2. ArtiCle Number

:~

(fransferfrom sep/ice

label)

7004

2890 0004

2296

4663

PS Form 3811, February 2004

Domestic Return Receipt

102595-02-Mi 540

DYes