OR~G
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RECE WED
CLERK’S OFFICE
DEC
t32004
STATE OF ILLINOIS
PolIut~an
Control Board
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Complete
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2
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3
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item 4 if
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is desired.
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PciAt
your.narne,~~ddress
on the reverse
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so that we can
return
the card to you.
B.
Received by
(PnntedN
C.
Date of Delivery
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Attach this
cat~p,~the
back of the mailpiece,
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or on the fmnt1J~tce
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D.
Is delivery address
differed
fi~m
item
1?
Ci Yes
1.
ArticIeAddressesF~
12/2/04
B.M.
,/
If YES,
enterdeliveryac(dress
below:
No
AC
2004—13
Johnna J..~P&thoff,Esq.
City of Chicago
Department of Environment
30
N. LaSalle Str~iet, Suite 2500 3~
i~e?ail
DExp,essMail
Chicago,
IL
606022575
V3
Reglstored
0
Return ReceiptforMorchandise
0
Insured
Mail
Ci
C.O.D.
4.
Restricted
Delivery?
(Extm
Fee)
0
yes
2.
Micle
Number
~
7~0040750
00043960
1864
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Form
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