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,

or on the front

if space permits.

1.

Arflcle Addressed to:

2

/3/

05

B

M.

AC 2005—32

Joseph

E.

Nack

Nack,

Richardson

& Kurt

J

R~C~JVED

CLERK’S OFFICE

FEB

142005

STATE OF ILLINOIS

Pollution

Control Board

—5-

~

A.

ature

(~\\~

~gb~t~

i~

~ ~1~\

~

~

0 A~re~ee

\l~’l~ “~Nr

4

:.~

‘

t~

~

~Q.~ec’~dby

~rin~Narn~

I

c. nate of

qelivyry

~

l

)

~,

/

D.

Is deliver~’hddress

different

fr~rn

~~15?-~..D5~

~y,/

If YES, enter delivery address b~iw:

106 North Main Street

P.O. Box 336

Galena,

IL 61036

3.

Sprvice Type

p-Certified Mail

D

Registered

0

Insured Mail

o

Express Mail

o

Return

Receipt for Merchandise

o

COD.

4.

Restricted

Delivery?

(Extra

Fee)

0

Yes

2.

Article Number

(rransferfrom service label)

7004

0750

0004

3960

2762

PS

Form

3811,

February 2004

Domestic Return Receipt

102595-02-M-1540