58371_NC DOT_20111117

Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
(Scale:
SAV: not sure yes no
i
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no'
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
tom,
Permit Officer's Signature '
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name
❑ CAMA / ❑ DREDGE & FILL
GENERAL PERMIT
Previous permit #
❑New ❑Modification ❑Complete Reissue
❑Partial Reissue Date previous permit issued
As authorized by the State of North Carolina, Department of Environment and Natural Resources
and the Coastal Resources Commission in an area of environmental concern pursuant to I SA NCAC
❑ Rules attached.
Applicant Name
Project Location: County
Address
Street Address/ State Road/ Lot #(s)
City State ZIP
Phone # ( ) Fax # O
Subdivision
Authorized Agent c
City ZIP
❑ CW ❑ EW ❑ PTA ❑ ES ❑ PTS
Phone # ( ) River Basin
Affected
AEC(s): ❑ OEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
Adj. Wtr. Body (nat /man /unkn)
❑ PWS: ❑ FC:
ORW: yes / no PNA yes / no Crit.Hab.
yes / no Closest Maj. Wtr. Body
Type of Project/ Activity
Pier (dock) length
Platform(s)
Finger pier(s)
Groin length
number
Bulkhead/ Riprap length
avg distance offshore
max distance offshore
Basin, channel
cubic yards
Boat ramp
Boathouse/ Boatlift
Beach Bulldozing
Other
Shoreline Length
(Scale:
SAV: not sure yes no
i
Sandbags: not sure yes no
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no'
A building permit may be required by: ❑ See note on back regarding River Basin rules.
Notes/ Special Conditions
Agent or Applicant Printed Name
Signature ** Please read compliance statement on back of permit **
Application Fee(s) Check #
tom,
Permit Officer's Signature '
Issuing Date Expiration Date
Local Planning Jurisdiction Rover File Name

Statement of Compliance and Consistency
This permit is subject to compliance with this application, site drawing and attached general and specific conditions. Any
violation of these terms may subject the permittee to a fine or criminal or civil action; and may cause the permit to become
null and void.
This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. The
applicant certifies by signing this permit that 1) prior to undertaking any activities authorized by this permit, the applicant will
confer with appropriate local authorities to confirm that this project is consistent with the local land use plan and all local
ordinances, and 2) a written statement or certified mail return receipt has been obtained from the adjacent riparian
landowner(s) .
The State of North Carolina and the Division of Coastal Management, in issuing this permit under the best available
information and belief, certify that this project is consistent with the North Carolina Coastal Management Program.
River Basin Rules Applicable To Your Project:
❑ Tar- Pamlico River Basin Buffer Rules ❑ Other:
❑ Neuse River Basin Buffer Rules
If indicated on front of permit, your project is subject to the Environmental Management Commission's Buffer Rules for the
River Basin checked above due to its location within that River Basin. These buffer rules are enforced by the NC Division of
Water Quality. Contact the Division of Water Quality at the Washington Regional Office (252-946-6481) or the Wilmington
Regional Office (910-796-7215) for more information on how to complywith these buffer rules.
Division of Coastal Management Offices
Raleigh Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293
Fax:[phone]
Morehead City Headquarters
400 Commerce Ave
Morehead City, NC 28557
252-808-2808/ 1-888ARCOAST
Fax: [phone]
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax: [phone]
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: [phone]
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-796-7215
Fax: [phone]
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
Revised 08/09/06

North Carolina
Beverly Eaves Perdue
Governor
November 17, 2011
NCDOT
c/o Clay Willis
113 Airport Dr., Suite 100
Edenton, N.C. 27932
Dear Mr. Willis:
NCDENR
Department of Environment and Natural Resources
Division of Coastal Management
Dee Freeman
Secretary
Attached is General Permit #58371 C to replace an existing culvert and relocate a water line at Juniper Trail,
Southern Shores, North Carolina.
In order to validate this permit, please sign the permit as indicated. Retain the white copy for your files and
return the signed yellow and pink copies to us in the enclosed, self-addressed envelope. If the signed permit
copies are not returned to this office before the initiation of development, you will be working without
authorization and will be subject to a Notice of Violation and subsequent civil penalties.
We appreciate your early attention to this matter.
Sincerely,
Stephen Lane
Coastal Management Representative
rcb
Enclosures
400 Commerce Ave., Morehead City, INC 28557
Phone: [phone] FAX: [phone] Internet: www.nccoastalmanagement.net
An Equal Opportunity 1 Affirmative Action Employer
NorthCarolina
Naturally

Applicant: ,N
1 Date: II -o-
Describe
-
Describe below the HABITAT disturbances for the application. All values should rnatch the name, and units of measurement
found in your Habitat code sheet.
Habitat Name
DISTURB TYPE
Choose One
TOTAL Sq, Ft.
(Applied for.
Disturbance total
includes any
anticipated
restoration or
tamp impacts)
Flf IAL Sq. Ft.
(Anticipated final
disturbance.
Excludes any
restoration
and/or temp
impact amount)
TOTAL Feet
(Applied for.
Disturbance
total includes
any anticipated
restoration or
temp impacts)
FIPdAL Feet
(Anticipated final
cli— •rb--nce.
Excludes any
restoration and/or
temp impact
amount
Dredge El-' Fill [g' Both []Other ❑
Dredge B- Fill [g• Both [g-1 Olher ❑
.y
bredge F-1" Fill Both (�Y" Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ ' Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ . Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other ❑
Dredge ❑ Fill ❑ Both ❑ Other Cl
e
''a52-308-2'.ois .. '•x•:313. • ;?C0A'aT ,. vr_v-.V.nc..:.

Lane, Stephen
From: Shook, Ryan L
Sent: Thursday, November 17, 2011 7:12 AM
To: Lane, Stephen
Subject: Juniper Trail Dare County
Stephen,
After talking with the Bridge Engineer, he feels they should have the project complete by the
Feb 15th moratorium. Let me know if you need any additional information in order to issue
the permit for this pipe replacement.
Thanks,
Ryan
Ryan Shook
Environmental Specialist
NCDOT - Division 1
113 Airport Dr., Suite 100
Edenton, NC 27932
Office 252-482-7977
Fax [phone]
Email correspondence to and from this sender is subject to the N.C. Public Records Law and
may be disclosed to third parties.
1

Lane, Stephen
From: Wilson, Travis W.
Sent: Tuesday, November 08, 2011 9:06 AM
To: Lane, Stephen
Subject: RE: Moratorium for Project in Dare County?
WRC request an in water work moratorium of February 15 to September 30 for this system. This is consistent with past
project commitments for work in this area.
Travis W. Wilson
Eastern Region Highway Project Coordinator
Habitat Conservation Program
NC Wildlife Resources Commission
1142 1-85 Service Rd.
Creedmoor, NC 27522
Phone: [phone] ext. 6
Fax: [phone]
[e-mail]
From: Lane, Stephen
Sent: Thursday, November 03, 20113:57 PM
To: Wilson, Travis W.
Subject: Moratorium for Project in Dare County?
Hi Travis,
NCDOT has proposed to replace an existing culvert on Juniper Trail, approximately 0.55 miles north of US158 in Southern
Shores, Dare County over a UT to Jean Guite Creek. I believe all of Jean Guite Creek is classified as an Inland PNA. The
proposed culvert is a 16'8" x 16'4" x 100' ASPP with headwalls and it is to replace a 14' x 16' x 88' CMP. DOT proposes to
install sheet pile at each end of the pipe and to work in the dry. Would you want any moratoriums/restrictions as far as
installing and removing the steel sheeting, or any other conditions? The latitude and longitude for the site is:
36' 6' 18" N
75' 43' 35" W
Let me know if you need any further information for the project.
Thanks,
Stephen
***** Note new E-mail Address is: Stephen.Lane(@ncdenr.gov *****
E-mail correspondence to and from this address may be subject to the North Carolina Public
Records Law and may be disclosed to third parties.
1

L - 1P
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
October 26, 2011
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave.
Morehead City, NC 28557
Dear Mr. Lane,
EUGENE A. CONTI, JR.
SF:('R[:']-:'\RY
This letter is requesting a general permit .2300 be issued for a pipe replacement on Juniper Trail, 0.552
miles north of US 158 in Dare County. The current pipe is failing and needs to be replaced to ensure safe
public travel. The existing pipe is 1 u! 14' x 16' x 88' CMP and will be replaced with the proposed I L
16'-8" x 16'-4" x 100' ASPP with headwalls. There is a 6" waterline located on the west side of the
existing pipe that will have to be relocated in order to accommodate the larger size of the proposed pipe.
The Division of Coastal Management considers the project area to be within an AEC that requires
authorization for the pipe replacement. Included with this request are the MP -1, MP -2, MP -5 forms,
location map, landowner notices, and permit drawings depicting the proposed work. The WBS element # is
36249.3083. If any additional information is needed please contact Ryan Shook at 252-482-7977.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, Division One
RECEIVED
OCT 2 7 2011
K. DCM-NIHD CITY
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

Dare County Juniper Trail

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52 Trinitie Trail
Kitty Hawk, NC'2794!
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William C. Silbefta�
30 Orchard Cov All
en G. BroadhurstVA
n
50 Juniper Trail *�
AW Southern Shores, NC 279
Russell Glo'ck Jr.
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Kitty Hawk, N 27949•
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52 Trinitie Trail
Kitty Hawk, NC'2794!
.
William C. Silbefta�
30 Orchard Cov All
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n
50 Juniper Trail *�
AW Southern Shores, NC 279
Russell Glo'ck Jr.
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DCM MP -1
APPLICATION for
Major Development Permit
(last revised 12/27/06)
North Carolina DIVISION OF COASTAL MANAGEMENT
1. Primary Applicant/ Landowner Information
Business Name
N.C. Department Of Transportation
Project Name (if applicable)
Juniper Trail Pipe Replacement
Applicant 1: First Name
Clay
MI
Last Name
Willis
Agent/ Contractor 2: First Name
Applicant 2: First Name
MI
Last Name
If additional applicants, please attach an additional page(s) with names listed.
City
Mailing Address
113 Airport Road
PO Box
City
Edenton
Phone No. 1
-
State
NC
ZIP
27932
Country
Phone No.
252 - 482 - 7977 ext.
FAX No.
252 - 482 - 8722
Street Address (if different from above)
City
State
State
ZIP
Email
[e-mail]
2. Agent/Contractor Information
Business Name
Agent/ Contractor 1: First Name
MI
Last Name
Agent/ Contractor 2: First Name
MI
Last Name
Mailing Address
PO Box
City
State
ZIP
Phone No. 1
-
ext.
Phone No. 2
ext.
FAX No.
Contractor #
Street Address (if different from above)
City
State
ZIP
Email
<Form continues on back>
RECEIVED
OCT 2 7 2011
DCM-MHD CITY

Form DCM MP -1 (Page 2 of 5)
APPLICATION for
Major Development Permit
3. Project Location
County (can be multiple)
Street Address
State Rd. #
Dare
Juniper Trail, 0.552 miles N. of US 158
n/a
Subdivision Name
City
State
Zip
Southern Shores
NC
27949 -
Phone No.
Lot No.(s) (if many, attach additional page with list)
- - ext.
Vegetation on tract
a. In which NC river basin is the project located?
b. Name of body of water nearest to proposed project
Pasquotank
Unnamed trib. (canal) to Jean Guite Creek .
c. Is the water body identified in (b) above, natural or manmade?
d. Name the closest major water body to the proposed project site.
❑Natural ®Manmade ❑Unknown
Currituck Sound
e. Is proposed work within city limits or planning jurisdiction?
f. If applicable, list the planning jurisdiction or city limit the proposed
®Yes ❑No
work falls within.
g.
Southern Shores
4.
Site Description
a.
Total length of shoreline on the tract (ft.)
b. Size of entire tract (sq.ft.)
65
2400
c.
Size of individual lot(s)
d. Approximate elevation of tract above NHW (normal high water) or
NWL (normal water level)
(If many lot sizes, please attach additional page with a list)
10 ❑NHW or ®NWL
e.
Vegetation on tract
Various roadside grasses on a maintained shoulder.
RECEIVED
f.
Man-made features and uses now on tract
0 C T 2 7 2011
Juniper Trail
4
i
T)CM_ IMT) CITY
g.
Identify and describe the existing land uses adiacent to the proposed project site.
Residential.
h.
How does local government zone the tract?
i. Is the proposed project consistent with the applicable zoning?
N/A
(Attach zoning compliance certificate, if applicable)
❑Yes ❑No ®NA
j.
Is the proposed activity part of an urban waterfront redevelopment proposal? ❑Yes ®No
k.
Hasa professional archaeological assessment been done for the tract? If yes, attach a copy. ❑Yes ®No ❑NA
If yes, by whom?
I.
Is the proposed project located in a National Registered Historic District or does it involve a ❑Yes ®No [INA
National Register listed or eligible property?
<Form continues on next page>
m. (i) Are there wetlands on the site? ❑Yes ®No
(ii) Are there coastal wetlands on the site? ❑Yes ®No
(iii) If yes to either (i) or (ii) above, has a delineation been conducted? ❑Yes ®No
(Attach documentation, if available)

Fora DCM MP -1 (Page 3 of 5)
n. Describe existing wastewater treatment facilities.
None
o. Describe existing drinking water supply source.
None
p. Describe existing storm water management or treatment systems.
None
APPLICATION for
Major Development Permit
5. Activities and Impacts
a. Will the project be for commercial, public, or private use? ❑Commercial ®Public/Government
❑Private/Comm unity
b. Give a brief description of purpose, use, and daily operations of the project when complete.
The purpose of this project is to replace the existing pipe that is structurally failing on Juniper Trail.
c. Describe the proposed construction methodology, types of construction equipment to be used during construction, the number of each type
of equipment and where it is to be stored.
Methods of construction will be concurrent with NCDOT Best Management Practices for the replacement of pipes. A crane,
tracked excavator, backhoe, and dump truck will be used during construction.
d. List all development activities you propose.
Replace the existing pipe 14'x 16'x 88' Corrugated Metal Pipe with 1 @ 16'-8" x 16'-4" x 100' Aluminum Structural Plate
Pipe with aluminum toewalls and riprap at the four comers for slope stabilization. The 6" waterline on the east side of the
project will be relocated.
e. Are the proposed activities maintenance of an existing project, new work, or both? Maintenance
f. What is the approximate total disturbed land area resulting from the proposed project? 2400 ®Sq.Ft or ❑Acres
g. Will the proposed project encroach on any public easement, public accessway or other area ❑Yes ®No ❑NA
that the public has established use of?
h. Describe location and type of existing and proposed discharges to waters of the state.
Surface runoff from Juniper Trail.
i. Will wastewater or stormwater be discharged into a wetland? ❑Yes ®No ❑NA
If yes, will this discharged water be of the same salinity as the receiving water? ❑Yes ❑No ❑NA
j. Is there any mitigation proposed? ❑Yes ®No ❑NA
If yes, attach a mitigation proposal.
<Form continues on back>
6. Additional Information
In addition to this completed application form, (MP -1) the following items below, if applicable, must be submitted in order for the application
package to be complete. Items (a) — (0 are always applicable to any major development application. Please consult the application
instruction booklet on how to properly prepare the required items below.
a. A project narrative.
b. An accurate, dated work plat (including plan view and cross-sectional drawings) drawn to scale. Please give the present status of the
proposed project. Is any portion already complete? If previously authorized work, clearly indicate on maps, plats, drawings to distinguish
between work completed and proposed.
c. A site or location map that is sufficiently detailed to guide agency personnel unfamiliar with the area to the site.
2r>2-806-2808 .. 1-868-4RCOf S-4 .. vw u.r�exGcs sYabmaroMyc� aa��rra2.at�i

Form DCM MP -1 (Page 4 of 5)
APPLICATION for
Major Development Permit
d. A copy of the deed (with state application only) or other instrument under which the applicant claims title to the affected properties.
e. The appropriate application fee. Check or money order made payable to DENR.
f. A list of the names and complete addresses of the adjacent waterfront (riparian) landowners and signed return receipts as proof that such
owners have received a copy of the application and plats by certified mail. Such landowners must be advised that they have 30 days in
which to submit comments on the proposed project to the Division of Coastal Management.
Name James H. Gradeless
Phone No.
Address 52 Trinitie Trail
Kitty Hawk, NC 27949
Name Steven G. Broadhurst
Phone No.
Address 50 Juniper Trail
Southern Shores, NC 27949
Name Russell Glock, Jr.
Phone No.
�_ R�C'vIVED
r'
Address 2 Sweetgum Ln
Kitty Hawk, NC 27949 OCT 2 7 2011
Name William C. Silberman
30 Orchard Cove Ln DCM-1,4HD CITY
Callao, VA 22135
g. A list of previous state or federal permits issued for work on the project tract. Include permit numbers, permittee, and issuing dates.
n/a
In. Signed consultant or agent authorization form, if applicable.
i. Wetland delineation, if necessary.
j. A signed AEC hazard notice for projects in oceanfront and inlet areas. (Must be signed by property owner)
k. A statement of compliance with the N.C. Environmental Policy Act (N.C.G.S. 113A 1-10), if necessary. If the project involves expenditure
of public funds or use of public lands, attach a statement documenting compliance with the North Carolina Environmental Policy Act.
1 7. Certification and Permission to Enter on Land
I understand that any permit issued in response to this application will allow only the development described in the application.
The project will be subject to the conditions and restrictions contained in the permit.
I certify that I am authorized to grant, and do in fact grant permission to representatives of state and federal review agencies to
enter on the aforementioned lands in connection with evaluating information related to this permit application and follow-up
monitoring of the project.

Form DCM MP -1 (Page 5 of 5)
APPLICATION for
Major Development Permit
I further certify that the information provided in this application is truthful to the best of my knowledge.
Date
Print Name Clay Willis, Division Environmental Officer
Signature ! '
Please indicate application attachments pertaining to your proposed project.
❑DCM MP -2 Excavation and Fill Information ®DCM MP -5 Bridges and Culverts
❑DCM MP -3 Upland Development
❑DCM MP -4 Structures Information
RECEIVED
OCT 2 7 2011
DCM ?,2HD CITY

Form DCM MP -2
EXCAVATION and FILL
(Except for bridges and culverts)
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
Describe below the purpose of proposed excavation and/or fill activities. All values should be given in feet.
1. EXCAVATION ®This section not applicable
a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated.
cubic yards.
c. (i) Does the area to be excavated include coastal wetlands/marsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
d. High -ground excavation in cubic yards.
OCT 2 7 2011
DCM-MHD CITY
2. DISPOSAL OF EXCAVATED MATERIAL ®This section not applicable
a. Location of disposal area. b. Dimensions of disposal area.
c. (i) Do you claim title to disposal area?
❑Yes ❑No ❑NA
(ii) If no, attach a letter granting permission from the owner
e. (i) Does the disposal area include any coastal wetlands/marsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
[-]CW []SAV [-]SB
OWL []None
(ii) Describe the purpose of disposal in these areas:
d. (i) Will a disposal area be available for future maintenance?
❑Yes [-]No ❑NA
(ii) If yes, where?
f. (i) Does the disposal include any area in the water?
[]Yes ❑No ❑NA
(ii) If yes, how much water area is affected?
Access
Other
Channel
Canal
Boat Basin
Boat Ramp
Rock Groin
Rock
(excluding
(NLW or
Breakwater
shoreline
NWL)
stabilization)
Length
Width
Avg. Existing
NA
NA
Depth
Final Project
NA
NA
Depth
1. EXCAVATION ®This section not applicable
a. Amount of material to be excavated from below NHW or NWL in b. Type of material to be excavated.
cubic yards.
c. (i) Does the area to be excavated include coastal wetlands/marsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
OWL ❑None
(ii) Describe the purpose of the excavation in these areas:
d. High -ground excavation in cubic yards.
OCT 2 7 2011
DCM-MHD CITY
2. DISPOSAL OF EXCAVATED MATERIAL ®This section not applicable
a. Location of disposal area. b. Dimensions of disposal area.
c. (i) Do you claim title to disposal area?
❑Yes ❑No ❑NA
(ii) If no, attach a letter granting permission from the owner
e. (i) Does the disposal area include any coastal wetlands/marsh
(CW), submerged aquatic vegetation (SAV), shell bottom (SB),
or other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
[-]CW []SAV [-]SB
OWL []None
(ii) Describe the purpose of disposal in these areas:
d. (i) Will a disposal area be available for future maintenance?
❑Yes [-]No ❑NA
(ii) If yes, where?
f. (i) Does the disposal include any area in the water?
[]Yes ❑No ❑NA
(ii) If yes, how much water area is affected?

3.* SHORELINE STABILIZATION This section not applicable
(If development is a wood groin, use MP -4 — Structures)
a. Type of shoreline stabilization:
❑Bulkhead ®Riprap ❑Breakwater/Sill ❑Other:
c. Average distance waterward of NHW or NWL: 3'
e. Type of stabilization material
riprap
g. Number of square feet of fill to be placed below water level.
Bulkhead backfill Riprap 96
Breakwater/Sill Other
i. Source of fill material.
b. Length: 32'
Width: 6-T
d. Maximum distance waterward of NHW or NWL: 3'
f. (i) Has there been shoreline erosion during preceding 12
months?
❑Yes ®No r-1 NA
(ii) If yes, state amount of erosion and source of erosion amount
information.
h. Type of fill material.
riprap
RECEIVED
OCT 2 7 2011
4. OTHER FILL ACTIVITIES ®This section not applicable
(Excluding Shoreline Stabilization) DCM_t;^HD CITY
a. (i) Will fill material be brought to the site? ❑Yes ❑No ❑NA
If yes,
(ii) Amount of material to be placed in the water
(iii) Dimensions of fill area
(iv) Purpose of fill
5. GENERAL
a. How will excavated or fill material be kept on site and erosion
controlled?
Using NCDOT Best Management Practices for soil and erosion
control.
C. (i) Will navigational aids be required as a result of the project?
❑Yes ®No ❑NA
(ii) If yes, explain what type and how they will be implemented.
Date
Juniper Trail pipe replacement, 0.552 mi. N. of US 158
Project Name
b. (i) Will fill material be placed in coastal wetlands/marsh (CW),
submerged aquatic vegetation (SAV), shell bottom (SB), or
other wetlands (WL)? If any boxes are checked, provide the
number of square feet affected.
❑CW ❑SAV ❑SB
❑WL ❑None
(ii) Describe the purpose of the fill in these areas:
b. What type of construction equipment will be used (e.g., dragline,
backhoe, or hydraulic dredge)?
tracked excavator, backhoe, dumptruck
d. (i) Will wetlands be crossed in transporting equipment to project
site? ❑Yes ®No ❑NA
(ii) If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
Clay Willis, Division Environmental Officer
Applicant Name
Applicant Signature ,

Form DCM MP -5
BRIDGES and CULVERTS
Attach this form to Joint Application for CAMA Major Permit, Form DCM MP -1. Be sure to complete all other sections of the Joint
Application that relate to this proposed project. Please include all supplemental information.
1. BRIDGES ®This section not applicable
a. Is the proposed bridge: b. Water body to be crossed by bridge:
❑Commercial ❑Public/Government ❑Private/Community
c. Type of bridge (construction material):
e. (i) Will proposed bridge replace an existing bridge? ❑Yes ❑No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge:
(v) Will all, or a part of, the existing bridge be removed?
(Explain)
9• Length of proposed bridge:
i. Will the proposed bridge affect existing water flow? ❑Yes ❑No
If yes, explain:
k. Navigation clearance underneath proposed bridge:
m. Will the proposed bridge cross wetlands containing no navigable
waters? ❑Yes ❑No
If yes, explain:
d. Water depth at the proposed crossing at NLW or NWL:
f. (i) Will proposed bridge replace an existing culvert? ❑Yes ❑No
If yes,
(ii) Length of existing culvert:
(iii) Width of existing culvert:
(iv) Height of the top of the existing culvert above the NHW or
NWL:
(v) Will all, or a part of, the existing culvert be removed?
(Explain)
h• Width of proposed bridge:
j. Will the proposed bridge affect navigation by reducing or
increasing the existing navigable opening? []Yes ❑No
If yes, explain:
I. Have you contacted the U.S. Coast Guard concerning their
approval? ❑Yes ❑No
If yes, explain:
n. Height of proposed bridge above wetlands:
2. CULVERTS ❑ This section not applicable
a. Number of culverts proposed: 1 b. Water body in which the culvert is to be placed:
Unnamed tributary (canal) to Jean Guite Creek.
< Form continues on back>
c. Type of culvert (construction material):
1 - 16'-8" x 16'-4" x 100' Aluminum Structural Plate Pipe
1..88.f 41140 AS :: Jnr v�r.�at craasYa@�� af�s en�ent. set
RECEIVED
OCT 2 7 2011
DCM-2f2I4D CITY
revised» 1026;06

r
d. ' (i) Will proposed culvert replace an existing bridge?
❑Yes ®No
If yes,
(ii) Length of existing bridge:
(iii) Width of existing bridge:
(iv) Navigation clearance underneath existing bridge:
(v) Will all, or a part of, the existing bridge be removed?
(Explain)
f• Length of proposed culvert: 100'
h. Height of the top of the proposed culvert above the NHW or NWL.
10'
j. Will the proposed culvert affect navigation by reducing or
increasing the existing navigable opening? ®Yes ❑No
If yes, explain: 2' increase in width
e. (i) Will proposed culvert replace an existing culvert?
®Yes ❑No
If yes,
(ii) Length of existing culvert(s): 88'
(iii) Width of existing culvert(s): 14'
(iv) Height of the top of the existing culvert above the NHW or
NWL: 10'
(v) Will all, or a part of, the existing culvert be removed?
(Explain) All
9. Width of proposed culvert: 16'-8"
i. Depth of culvert to be buried below existing bottom contour.
1'
k. Will the proposed culvert affect existing water flow?
®Yes ❑No
If yes, explain: Enhance hydrologic flow regimes.
3. EXCAVATION and FILL [I This section not applicable
a. (i) Will the placement of the proposed bridge or culvert require any b. (i) Will the placement of the proposed bridge or culvert require any
excavation below the NHW or NWL? ®Yes ❑No excavation within coastal wetlands/marsh (CW), submerged
If yes, aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
(ii) Avg. length of area to be excavated: 100' feet affected.
(iii) Avg. width of area to be excavated: 20' ❑CW [—]SAV ❑SB
(iv) Avg. depth of area to be excavated: 2' ❑WL ®None
(v) Amount of material to be excavated in cubic yards: 148
(ii) Describe the purpose of the excavation in these areas:
c. (i) Will the placement of the proposed bridge or culvert require any
high -ground excavation? ®Yes ❑No
If yes,
(ii) Avg. length of area to be excavated: 85'
(iii) Avg. width of area to be excavated: 30'
(iv) Avg. depth of area to be excavated: 2'
(v) Amount of material to be excavated in cubic yards: 189
rR' " RECENED
r
OC1 � 7 2011
Dr *,rI:D C;TY
<'_i -#tGi tii of :: 1,688-4ti+wC AST rrwwr.r)cco�i-,t irr7att-,.igemerlt.rset ravvs"e'i: int;

d.' If the placement of the bridge or culvert involves any excavation, please complete the following:
(i) Location of the spoil disposal area: NCDOT approved waste area site.
(ii) Dimensions of the spoil disposal area: N/A
(iii) Do you claim title to the disposal area? ®Yes ❑No (If no, attach a letter granting permission from the owner.)
(iv) Will the disposal area be available for future maintenance? ®Yes ❑No
(v) Does the disposal area include any coastal wetlands/marsh (CW), submerged aquatic vegetation (SAVs), other wetlands (WL), or shell
bottom (SB)?
❑CW ❑SAV OWL ❑SB ®None
If any boxes are checked, give dimensions if different from (ii) above.
(vi) Does the disposal area include any area below the NHW or NWL? ? ❑Yes ®No
If yes, give dimensions if different from (ii) above.
e. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed below NHW or NWL? ®Yes ❑No
If yes,
(ii) Avg. length of area to be filled: 12
(iii) Avg. width of area to be filled: 16'-8"
(iv) Purpose of fill: Placement of proposed pipe that is 12'
longer than existing pipe and 16'-8" wide.
g. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed on high -ground? ®Yes ®No
If yes,
(ii) Avg. length of area to be filled: 10'
(iii) Avg. width of area to be filled: 16'
(iv) Purpose of fill: Widening of the shoulders over the top
of the proposed pipe.
4. GENERAL
a. Will the proposed project require the relocation of any existing
utility lines? ®Yes ❑No
If yes, explain: The 6" waterline on the east side of the
project will be relocated to the depth and location shown
on the permit drawings.
If this portion of the proposed project has already received
approval from local authorities, please attach a copy of the
approval or certification.
f. (i) Will the placement of the proposed bridge or culvert result in any
fill (other than excavated material described in Item d above) to
be placed within coastal wetlands/marsh (CW), submerged
aquatic vegetation (SAV), shell bottom (SB), or other wetlands
(WL)? If any boxes are checked, provide the number of square
feet affected.
❑CW _ ❑SAV ❑SB
❑WL ®None
(ii) Describe the purpose of the excavation in these areas:
11 . RECENED
OCT 2 7 2011
Dr'M-MIOD CITY
b. Will the proposed project require the construction of any temporary
detour structures? []Yes ®No
If yes, explain:
< Form continues on back>
c. Will the proposed project require any work channels? d. How will excavated or fill material be kept on site and erosion
❑Yes ®No controlled?
If yes, complete Form DCM-MP-2. Using NCDOT best management practices for sediment
and erosion control.
� ` �Qa# • 2 t:3i3 :: 1-1388.4RCOX—iT :: WV, w tai:coast&aIIII a wM aigvmvTtt.Viet

r ,
e. What type of construction equipment will be used (for example,
dragline, backhoe, or hydraulic dredge)?
crane, tracked excavator, dumptruck, backhoe
g. Will the placement of the proposed bridge or culvert require any
shoreline stabilization? ®Yes ❑No
If yes, complete form MP -2, Section 3 for Shoreline
Stabilization only.
LOZ4 bl
Date
Juniper Trail pipe replacement, 0.552 miles N. of US 158
Project Name
Clay Willis, Division Environmental Officer
plicant Namea ) -
p
plicant Signature
f. Will wetlands be crossed in transporting equipment to project site?
❑Yes ®No
If yes, explain steps that will be taken to avoid or minimize
environmental impacts.
RECEIVED
OCT 2 7 2011
DCM-MHD CITY
..i • 3&xri-zkiistS888-4fO.::i Asa r :, revised: 10;2f' 0b

STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
October 12, 2011
James H. Gradeless
52 Trinitie Trail
Kitty Hawk, NC 27949
To Whom It May Concern,
EUGENE A. CONTI, JR.
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace a metal pipe on
Juniper Trail in Dare County. The pipe is located approximately 0.552 miles north from
the intersection of US 158. The existing pipe is 14' x 16' x 88' Corrugated Metal Pipe
and the proposed pipe is 16'-8" x 16'-4" x 100' Aluminum Structural Plate Pipe with
headwalls. There is a 6" waterline located under the west side of the existing pipe that
will have to be relocated in order to accommodate the larger size of the proposed pipe.
The Division of Coastal Management (DCM) considers the adjacent waters to be
public trust waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, the permit application, along with a
design plat is included with this letter. If you have any questions concerning the proposed
work you can contact Ryan Shook at 252-482-7977.
ILECF,WED
OCT 2 7 2011
DCM-MHD CITY
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
If you do have objections to the project, please forward your comments to:
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave
Morehead City, NC 28557
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, Division One
RECENED
OCT 2 7 2011
DCM-M" CITY

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: Juniper Trail, 0.552 mi. N. of US 158)
I, , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on Juniper Trail. I am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (CAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:
FXCENED
w 21 2011
DCM_-�1IAM CITY

STATE OF NORTH CAROLINA
ru i .� • r::. • : : • .
BEVERLY EAVES PERDUE
GOVERNOR
October 12, 2011
Steven G. Broadhurst
50 Juniper Trail
Southern Shores, NC 27949
To Whom It May Concern,
EUGENE A. CONTI, JR.
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace a metal pipe on
Juniper Trail in Dare County. The pipe is located approximately 0.552 miles north from
the intersection of US 158. The existing pipe is 14' x 16' x 88' Corrugated Metal Pipe
and the proposed pipe is 16'-8" x 16'-4" x 100' Aluminum Structural Plate Pipe with
headwalls. There is a 6" waterline located under the west side of the existing pipe that
will have to be relocated in order to accommodate the larger size of the proposed pipe.
The Division of Coastal Management (DCM) considers the adjacent waters to be
public trust waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, the permit application, along with a
design plat is included with this letter. If you have any questions concerning the proposed
work you can contact Ryan Shook at 252-482-7977.
RF.0'ENBD
OC, 2'1 2011
DCM-1•"-HD C=TY
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
If you do have objections to the project, please forward your comments to:
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave
Morehead City, NC 28557
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willisege�- 4z 'r
Environmental Officer, Division One
PTC,,VSD
0c, 21ZV
vcht,,!,RD crrY

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: Juniper Trail, 0.552 mi. N. of US 158)
I, , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on Juniper Trail. I am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (LAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:
r'TaIVE-D
OCA 21 2V

a..+ STATt u
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
October 12, 2011
Russell Glock, Jr.
2 Sweetgum Lane
Kitty Hawk, NC 27949
To Whom It May Concern,
EUGENE A. CONTI, JR.
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace a metal pipe on
Juniper Trail in Dare County. The pipe is located approximately 0.552 miles north from
the intersection of US 158. The existing pipe is 14' x 16' x 88' Corrugated Metal Pipe
and the proposed pipe is 16'-8" x 16'-4" x 100' Aluminum Structural Plate Pipe with
headwalls. There is a 6" waterline located under the west side of the existing pipe that
will have to be relocated in order to accommodate the larger size of the proposed pipe.
The Division of Coastal Management (DCM) considers the adjacent waters to be
public trust waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, the permit application, along with a
design plat is included with this letter. If you have any questions concerning the proposed
work you can contact Ryan Shook at 252-482-7977.
OCT 2 7 2011
DCM4,RHD CITY
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
If you do have objections to the project, please forward your comments to:
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave
Morehead City, NC 28557
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P.E.
Division Engineer, Division One
Clay Willis
Environmental Officer, Division One
cc, 2'1ZV
rt*.7J CIV

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: Juniper Trail, 0.552 mi. N. of US 158)
I, , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on Juniper Trail. I am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (LAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:
RECEIVED
OCT 27201
DCM-MHD Cny

e H. STATE o
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
BEVERLY EAVES PERDUE
GOVERNOR
October 12, 2011
William C. Silberman
30 Orchard Cove Ln
Callao, VA 22135
To Whom It May Concern,
EUGENE A. CONTI, JR.
SECRETARY
CERTIFIED MAIL
The NC Department of Transportation is proposing to replace a metal pipe on
Juniper Trail in Dare County. The pipe is located approximately 0.552 miles north from
the intersection of US 158. The existing pipe is 14' x 16' x 88' Corrugated Metal Pipe
and the proposed pipe is 16'-8" x 16'-4" x 100' Aluminum Structural Plate Pipe with
headwalls. There is a 6" waterline located under the west side of the existing pipe that
will have to be relocated in order to accommodate the larger size of the proposed pipe.
The Division of Coastal Management (DCM) considers the adjacent waters to be
public trust waters under their regulations. Therefore, it is provided protection under state
law. For this reason the NCDOT will apply for a permit from the DCM to perform the
described work. Part of the permit process is notifying the adjacent landowners of the
proposed work. A map depicting the project area, the permit application, along with a
design plat is included with this letter. If you have any questions concerning the proposed
work you can contact Ryan Shook at 252-482-7977.
RECEIVED
OCT 2 7 2011
DCM-2,111D CITY
113 Airport Drive, Suite 100, Edenton, NC 27932, Phone [phone], Fax [phone]

The attached form is submitted to insure that you have an opportunity to comment
on the proposal. The work is depicted on the attached drawings. If you have no objects to
the proposal, please return the form with your response within ten (10) days to this office.
If you do have objections to the project, please forward your comments to:
Stephen Lane
NC Division of Coastal Management
400 Commerce Ave
Morehead City, NC 28557
No response within ten (10) days will be construed to mean you have no objections.
Thank you for your cooperation.
Sincerely,
Jerry Jennings, P. E.
Division Engineer, Division One
Clay Willis
oyi
Environmental Officer, Division One
RECEIVED
OCT 2 7 2011
DCM-?-.IHD CITY

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: Juniper Trail, 0.552 mi. N. of US 158)
I, , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on Juniper Trail. I am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (LAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached.
I have objections to the project as presently proposed and my comments
Signature of Adjacent Landowner
Date:
UCENED
OCT 2 7 2011
DCM-M1411) CITY

ADJACENT RIPARIAN LANDOWNER STATEMENT
(Dare County: Juniper Trail, 0.552 mi. N. of US 158)
I, ,fsc�t/ 4�/atn—x , am an adjacent riparian property owner and am
aware of the North Carolina Department of Transportation's plans for the pipe
replacement on Juniper Trail. I am further aware that this work will occur in an AEC and
therefore will require authorization from the Division of Coastal Management in
accordance with the Coastal Area Management Act (LAMA).
I have no objection to the project as presently proposed and hereby waive
that right of objection as provided in General Statute 113-229.
are attached.
I have objections to the project as presently proposed and my comments
i o gnat, r e OFA cent Lando' ' Cr
Date: /o�///
RECEIVED
OCT 2 7 2011
DCM-MHD CITY
11VISION
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(DomesticProvided)
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_____ 2 Sweetgum Lane
----------- .
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01Pt Kitty Hawk, NC 27949,CT 2 7 2011 ______

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■ For an additional fee, a Return Receipt may be requested to provide proof of l
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■ For an additional fee, delivery may be restricted to the addressee or
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PS Form 3600, August 2006 (Reverse) PSN 7530-02-000-9047

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Sen dames H. Gradeless l�D
o Stre 52 Trinitie Tr_a(�i�_,!.
C3 or Kitty Hawk, V( 27949
city
Postaa CO
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valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPSe postmark on your Certified Mail receipt is
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■ For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
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cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT, Save this receipt and present it when making an inquiry.
PS Form 3800, August 2006 (Reverse) PSN 7530.02-000-9047

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Sent Steven G. Broadhurst U
i p -- Sher 50 Juniper Trail ---------
C3
or P(Southern Shores, NC 27949
r. ...... .----------
city,

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delivery. To obtain Return Receipt service, please complete and attach a Return
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cle at the post office for postmarking. if a postmark on the Certified Mail f
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT, Save this receipt and present it when making an inquiry.
PS Form 3800, August 2005 (Reverse) PSN 7530-02-000-9047

1
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30 Orchard Cove Ln
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■ A record of delivery kept by the Postal Service for two years
Important Reminders:
■ Certified Mail may ONLY be combined with First -Class Mail® or Priority Mails.
■ Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is
required.
■ For an additional fee, delivery may be restricted to the addressee or ,
addressee's authorized agent. Advise the clerk or mark the mailpiece with the `
endorsement "Restricted Delivery".
■ If a postmark on the Certified Mail receipt is desired, please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail !
receipt is not needed, detach and affix label with postage and mail.
IMPORTANT: Save this receipt and present it when making an inquiry.
PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047

■ 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.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to: a�
A
W Cn
Russell Glock, Jr.
2 Sweetgum Lane a
` Kitty Hawk, NC 27949
CDi
A. Sig 6f re
ge
X
�1�0 dc
B. Received by (Pdn e) , C. Dat of [
D. Is delivery address different from item 1 ? 0 Yes
If YES, enter delivery address below: 0 No
3. Service Type
Mr,ertified Mail
0 Registered
0 Insured Mail
0 Express Mail
0 Return Receipt for Merchandise 's
0 C.O.D.
4. Restricted Delivery? (Extra Fee) 0 Yes
2, Article Number 7009 2820 0003 3736 9931
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATVqp- P RL SMIP x4
14 -0c.7,
• Sender: Please print your name, address, and ZIP+4 in this box •
NG DEPT OF TRANSPORTATION
DIVISION OFFICE
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932
COURIER: 10-51-02
Hli.-Il 1:4

■ ComplOte 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.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
William C. SilbermanO O
30 Orchard Cove Ln w ti
Callao, VA 22135 �w cV 4
O
A. S nature l
X C yin O„'/ ent
Addressee
B. aeive by ( Printed ame) C. Date iyery
115; f
D. Is delivery address different frorA Rem 1?Ye
If YES, enter delivery address below: No
3. Service Type
Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
700,9 2820 0003 3736 9948
(transfer from service label) ---" —
Domestic Return Receipt 102595-02-M-1540
PS Form 3811, February 2004 - - - - - -.

UNITED STATES POSTAL SERVICE FIfSt-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
NO DEPT OF TRANSPORTATION
DIVISION OFFICE
113 AIRPORT DRIVE, SUITE 100
EDENTON, NO 27932
COURIER: 10-51-02

■ 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.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
James H. Gradeless n N
52 Trinitie Trail w
Kitty Hawk, NC 27949'
A.
❑ Agent
❑ Addressee y
Received by//( Printed Name) C. Date of Delivery j
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address"below: ❑ No
3. Service Type
®'Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
r2. Article Number 7009 2820 0003 3738 3722
(Transfer from service label)
Domestic Return Receipt 102595-02-M-1540
PS Form 3811, February 2004 _

UNITED STATES POSTAL SERVICE
First•ClasS Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
NC DEPT OF TRANSPORTATION
DIVISION OFFICE
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932
COURIER: 10-51-02

■ compieie items i, z, ana 3. Hiso compiete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed tc BROA0 5 0 * T2 7 9 4 92 0 51
Steven G. Bro
50 Juniper Tri
Southern Sho
P, -
1711 4
�J
BROADRURST' STEVEN 0,�-Av
8108 BRIGHT POND WAY
MNASSAS VA 20111-5243
C
1Q�15/11
F-'
IIIIIIIIIIII�i III I�II���I9I II11 �IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII III
Cl Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number- 7009 2820 0003 3736 9955
(Transfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-15

UNITED STATES POSTAL SERVICE lifst-Cla MaW.
nqab��e :.teQaid
(JSI;,S
• Sender: Please print your name, address, and ZI P+4- h -this box •
NG DEPT OF TRANSPORTATION
DIVISION OFFICE
113 AIRPORT DRIVE, SUITE 100
EDENTON, NC 27932
COURIER: 10-51-02
&ov\
I