17C-103 CERTIFIED RECEIPT *ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,''and 3. �n =
• Print your name and address on the reverse 7 �i'� � 0 Agent
so that we can return the card to you. ❑Addresse
• Attach this card to the back of the mailpiece,' ° ' ived by(Printed Name) C. D to of D 1(ver!
or on the front if space permits. �,� ..,�"'_.�4-- - s-- .`
1. Article Addressed to: D. Is delivery address different from item
If YES,enter delivery address below: 0 No
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I III I III 1111 I I I II I I I I I IIII I I 3. de Type ❑Priority Mail Express®
❑Adult Signature ❑Registered MaiITM
❑Adult Signature Restricted Delivery 0 Registered Mall Restrict
❑Certified Mail® Delivery
9590 9402 1770 6074 1587 29 ❑Certified Mail Restricted Delivery ❑Return Receipt for
❑Collect on Delivery Merchandise
2. Article Number(Transfer from service label) 0 Collect on Delivery Restricted Delivery 0 Signature Confirmation
r, -..--a Mail 0 Signature Confirmation
7016 3 56 01 C 0 0 0 1918 6762 Mal Restricted Delivery00) Restricted Delivery
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipi
USPS TRACKING#
111 First-Class Mail
fli i jfk Postage&Fees Paid
USPS
1[1114.11
Permit No.G-10
gcan _ y 1:.187 29
United States •Sender Please print your name,address,and ZIP+4®in this box*
Postal Service
CITY OF NORTHAMPTON
DIPT OF BUILDING INSPECTIONS
212 MAIN STREET
NORTHAIQTTON.MA 01000