ORIGINAL
    RECE~VED
    CLERK’S OFFICE
    FEB
    032005
    STATE OF
    ILUNOIS
    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.
    U Attach
    this card to the back ol the mailpiece,
    or on the front if space permits.
    1.
    Article Addressed to:
    1/20/05
    B
    .N.
    AC 2005—034
    Troy D.
    Holland
    LaSalle County Courthouse
    A. Signatw~
    x
    ~
    ~ent
    0
    Addressee
    Is delivery add~tss
    different fro~i’item1?
    0
    Yes
    If YES, enter delivery address below:
    C.
    Date of Delivery
    i
    707 Etna Road
    P.O. Box 430
    Ottawa,
    IL 61350
    2.
    Article!
    (rraflsfE
    PSForm~
    o
    Express Mail
    o
    Return Receipt for Merchandise
    o
    C.O.D.
    .4
    n~....*.$...•.-..4
    fl.-.fl. ......fl
    IC......
    C..._~
    ‘)
    Yes
    B. Received
    ~y(Pririted Name)
    6(’-
    J0.I’~.s~
    3.
    ServIce Type
    o
    Certified Mail
    o
    Registered
    o
    Insured Mail..
    ~95-O2-M-ls4O

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