CLERK’S
OFFICE
OCT
o
BEFORE THE ILLINOIS POLLUTION
CONTROL BOARD
STATE
OF
ILLINOIS
CITY OF CHICAGO DEPARTMENT
)
~~~lUtion
Con
troj Board
OF ENVIRONMENT,
)
)
Complainant,
)
)
v.
)
AC
04-14
)
(CDOENo. 03-03-AC)
KAZIMIERZ SOBKO
)
)
)
)
Respondent.
)
NOTICE OF. FILING
To:
Kazimierz Sobko
PLEASE TA~NOTICE that on
~,
~we
caused the following instrument(s)
entitled PROOF OF
SERVICE to be filed with the clerk ofthe Illinois Pollution Control Board.
CITY OF CHICAGO
DEPARTMENT
OF ENVIRONM
T
By1/~
~
Johriui~tJ
o
off
Assistant Commissioner
Permitting and Enforcement Divisi
n
PROOF OF
SERVICE
~RE:.
iq&o
~
~DOE
~C~
OVN
NUMBER
Notice
ofViolation
and
other
required pleadings, as required
by law, were
served
on
the
above
captioned
individual or
entity
by the
means
indicatedbelow.
By
PERSONAL
SERVIcE
upon
the individual/entity
or
their
employee or agent.
O
Refused to sign for receipt ofservice.
___________
_________
SERVERS INITIALS
DatE’
K
NAME
OF PERSON SERVED
POsmoN/cAPAcITY
(I.E.,
A
ENT)
o
Personal
service
of
bearing
notice.
__________
________
S~v~.s
e1rrt,1.s
Dete
SIGNATLTREJ
NAME
OF PERSON SERVED
POSITION/CAPACITY
(I.E., AGENT)
0
By
FIRST
CLASS U.S.
MAIL,
postage prepaid.,
to
the last known address
ofrecord ofthe
individual/entity
or
their registered agent
on
This
_____
day
of______________
_______
MAILING ADDRESS
0
By
CERTIFIED
MAIL
(return receiptrequested) to the
last known
address ofrecord ofthe
individual/entity or
their registered
agent.
RECEIPT
NUMBER
DATE
D
By
EXPRESS
OR OVERNIGHT
CARRIER
to
the last known
address ofrecord of
the
individuaVentity or
their
registered agent.
CARRIER
TRACKING
CODE
DATE
CERTIFICATION
i,
4o~
~
~o hereby ce~ifyunderthreat of penalty provided pu~uantto
735 1LCS 5/1-109, that the Ordinance Violation Notice and other required documents were
served on th
ove nam
individual/entity or their agent in the manner indicated.
Io1t~~
SIGNATURE
OF
SERVER
DATE