RECEWED

CLERK’S OFFICE

FEB 1 42005

STATE OF ILLINOIS

PoflutiOn Control Board

SENDER

COMPLETE THIS SECTION

COMPLETE THIS SECTION ON DELIVERY

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

A. Signat1~e

item 4 if Restricted Delivery is desired.

0 Agent

0 Addressee.

• Print your name and address on the reverse

____________________________________________

so that we can return the card to you.

~A~ceived

~yfPrinted Name)

‘C. Date of Delive~

• Attach this card to the back of the mailpiece,

~

~—

,~‘—

~s

or on the front if space permits.

D. Is detvery address different frem item 1? 0 Yes

If YES, enter delivery address below:

0 No

1. Article Addressed to

2/3/05 B. M.

PCB 2005—144

Ken Maschhoff

Bay Creek 3 Investments

RR 1, Box 210B

3 Service Type

Nebo,

IL 62355

-Certified Mail 0 Express Mail

lb

Registered

0 Return Receipt for’Merchandise

0 Insured Mail

0 C.O.D.

4. Restricted Delivery?

(Extra Fee)

0 Yes

2. Article Number

(Transfer from se,vicé Iab&)

7004 0750 0004 3960 2724

PS Form

3811.,

February 2004

DomesticReturn Receipt

102595-02-M-1

540