Hand-Delivered Receipt - CE-2016-0004.tif i
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DATE LETTER PREPARED: Jan. 13, 2016
1 have received a letter addressed to:
OK TIRE
770 WASHINGTON ST
BLAIR, NE 68008
RE: 770 Washingt n Street
Signat "f*ersow�eiving letter
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Printed name of pe s n receiving letter
Signat of pe n delivering letter
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Date and ti e f delivery
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218 S 16th Street•Blair,Nebraska 68008 •402.426.4191 •FAX 402.426.4195 •E-mail: eityolblair@ci.blair.ne.us