HomeMy WebLinkAbout39342_NC DOT_20040714❑CAMA /,-]DREDGE &FILL
GENERAL PERMIT
Previous permit #
❑New —]Modification ❑Complete Reissue -]]Partial Reissue Date previous permit issued i
As authorized by the State of North Carolina, Department of Environment and Natural Resources j
and the Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC L
❑ Rules attached.
Applicant Name i� t_ ` f Project Location: County
Address x J k7 Street Address/ State Road/ Lot #(s)
City �.k State j ZIP ' ��?� P.11 l�,
Phone # ( ) (> % 0 Fax # ( )
Authorized Agent 3. y 'CC1117
L-7 CW 2 EW El PTA SES ❑ PTS
Affected ElOEA ❑ HHF ❑ IH ❑ UBA ❑ N/A
AEC(s):
❑ PWS: ❑ FC:
ORW: yes/ no PNA yes / no Crit. Hab. yes / no
Subdivision
City �"T : ZIP
Phone # ( ) River Basin
Adj. Wtr. Body f '' l f ' t "F } (nat /man /unkn)
Closest Maj. Wtr. Body
Type of Project/ Activity
(Scale:' �"
)
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
j
Other.._..: , ✓'{4 ;.! cr��r
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Shoreline Length
SAM not sure yes no
Sandbags: not sure yes no -
Moratorium: n/a yes no
Photos: yes no
Waiver Attached: yes no
A building permit may be required by:
Notes/ Special Conditions
! I
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See note on back regarding River Basin rules.
TeN V "T?'!/\tt 101
Agent or Xpplicant Printed Name _ \
Signature Please read compliance statement on back of permit **
o rv-)
Application Fee(s) Check #
Permit Officer's Signature
Issuing Date �., Expi tion Date
Local Planningf urisdiction 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 I) 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 (910-395-3900) for more information on howto complywith thesebuffer rules.
Division of Coastal Management Offices
Central Office
Mailing Address:
1638 Mail Service Center
Raleigh, NC 27699-1638
Location:
Parker -Lincoln Building
2728 Capital Blvd.
Raleigh, NC 27604
919-733-2293 / 1-888-4RCOAST
Fax:919-733-1495
Elizabeth City District
1367 U.S. 17 South
Elizabeth City, NC 27909
252-264-3901
Fax:252-264-3723
(Serves: Camden, Chowan, Currituck,
Dare, Gates, Pasquotank and Perquimans
Counties)
Morehead City District
151-B Hwy. 24
Hestron Plaza II
Morehead City, NC 28557
202-808-2808
Fax: 252-247-3330
(Serves: Carteret, Craven, Onslow -above
New River Inlet- and Pamlico Counties)
Washington District
943 Washington Square Mall
Washington, NC 27889
252-946-6481
Fax: 252-948-0478
(Serves: Beaufort, Bertie, Hertford, Hyde,
Tyrrell and Washington Counties)
Wilmington District
127 Cardinal Drive Ext.
Wilmington, NC 28405-3845
910-395-3900
Fax:910-350-2004
(Serves: Brunswick, New Hanover,
Onslow -below New River Inlet- and
Pender Counties)
www.nccoastalmanagement.net
Revised 10/05/01
Form DCM-MP-S
BRIDGES AND
CULVERTS
o" r
JUL 0 E 2004
Morehead City DC1V9
$100.00 CAMA Processing Fee NCDOT WBS Element Number 2.200711
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.
1. BRIDGES (N/A)
a. Public X Private
b. Type of bridge (construction material)
N/A
c. Water body to be crossed by bridge
N/A
d. Water depth at the proposed crossing at MLW or
NWL N/A
e. Will proposed bridge replace an existing bridge? N/A
_ _Yes No
If yes,
(1) Length of existing bridge
(2) Width of existing bridge
(3) Navigation clearance underneath existing
bridge
(4) Will all, or a part of, the existing bridge be
removed? (Explain).
f. Will proposed bridge replace an existing culvert(s)?
N/A
Yes _ _No
If yes,
(1) Length of existing culvert
(2) Width of existing culvert
(3) Height of the top of the existing culvert above
the MHW or NWL
(4) Will all, or a part of, the existing culvert be
removed? (Explain)
g. Length of proposed bridge.
h. Width of proposed bridge
i. Height of proposed bridge above wetlands
j. Will the proposed bridge affect existing water flow?
N/A
_ _Yes No
If yes, explain,
k. Navigation clearance underneath proposed bridge
N/A
1. Will the proposed bridge affect navigation by
reducing or increasing the existing navigable
opening? _ _Yes _ No N/A
If yes, explain
m. Will the proposed bridge cross wetlands containing
no navigable waters? Yes _ No N/A
If yes, explain
n. Have you contacted the U.S. Coast Guard concerning
their approval? N/A
Yes _ No
If yes, please provide record of their action.
2. CULVERTS
a. Water body in which culvert is to be placed
Tributary of Pamlico River
b. Number of culverts proposed Two
c. Type of culvert (construction material, style)
46' x 48" aluminum corrugated Dines
d. Will proposed culvert replace an existing bridge?
Yes _X No
If yes,
(1) Length of existing bridge
(2) Width of existing bridge
(3) Navigation clearance underneath existing
bridge
Revised 03/95
zi-y''),
Form DCM-MP-5
(4) Will all, or a part of, the existing bridge be
removed? (Explain)
e. Will proposed culvert replace an existing culvert?
X _Yes No
If yes,
(1) Length of existing culvert 1@44' g46'
(2) Width of existing culvert 1@24" W48"
(3) Height of the top of the existing culvert above
the MHW or NWL 1.3'/2.1'
(4) Will all, or a part of, the existing culvert be
removed? (Explain) All removed
f. Length of proposed culvert46'
g. Width of proposed culvert 48"
h. Height of the top of the proposed culvert above the
MHW or NWL 1.3'
i. Will the proposed culvert affect existing water flow?
_X—Yes _No
If yes, explain Allow greater flow during storm
events
Will the proposed culvert affect existing navigation
potential? Yes --No N/A
If yes, explain
3. EXCAVATION AND FILL
a. Will the placement of the proposed bridge or culvert
require any excavation below the MHW or NWL?
_ X_
Yes _ —No
If yes,
(1)
Length of area to be excavated 50'
(2)
Width of area to be excavated 17'
(3)
Depth of area to be excavated 1.6'
(4)
Amount of material to be excavated in cubic
yards 850sq. ft.
b. Will the placement of the proposed bridge or culvert
require any excavation within:
X Coastal Wetlands _ SAVs Other Wetlands
If yes,
(1) Length of area to be excavated 6'
(2) Width of area to be excavated 6'
(3) Approximate area to be excavated 36 sq. ft.
c. Will the placement of the proposed bridge or culvert
require any highground excavation?
X Yes No JUk 0 2 2004
If yes, AA
(1) Length of area Me d 50'
(2) Width of area to be eOM, pp
(3) Amount of material to be excavate in c
yards 850 sq. ft.
d. If the placement of the bridge or culvert involves any
excavation, please complete the following:
(1) Location of the spoil disposal area
Temporary spoil area is existing road bed
(2) Dimensions of spoil disposal area
20' x 20'
(3) Do you claim title to the disposal area?
X Yes No
If no, attach a letter granting permission from
the owner.
(4) Will the disposal area be available for future
maintenance? X Yes No
(5) Does the disposal area include any coastal
wetlands (marsh), SAVs, or other wetlands?
Yes X No
If yes, give dimensions if different from (2)
above.
(6) Does the disposal area include any area below
the MHW or NWL? Yes X No
If yes, give dimension if different from No. 2
above.
e. 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 MHW
or NWL? _ _Yes X _No
If yes,
(1) Length of area to be filled
(2) Width of area to be filled
(3) Purpose of fill
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 _ SAVs Other Wetlands
If yes, Open Water Impacts = (Culvert)
(1) Length of area to be filled 12'
(2) Width of area to be filled 12'
(3) Purpose of fill 144sg. ft.
g. 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
highground? Yes _ _No
If yes,
(1) Length of area to be filled
Revised 03/95
Form DCM-MP-5
(2) Width of area to be filled
(3) Purpose of fill
JUL 0 2 2004
4. GENERAL
Morehead City [ACM
a. Will the proposed project involve any mitigation?
Yes X No
If yes, explain in detail
181
Will the proposed project
any existing utility lines?
If yes, explain in detail
require the relocation of
Yes X No
c. Will the proposed project require the construction of
any temporary detour structures?
Yes X No
If yes, explain in detail
d. Will the proposed project require any work channels?
Yes X No
If yes, complete Form DCM-MP-2
e. How will excavated or fill material be kept on site
and erosion controlled? Silt fence
f. What type of construction equipment will be used
(for example, dragline, backhoe or hydraulic dredge)?
Typical culvert construction equipment
g. Will wetlands be crossed in transporting equipment to
project site? Yes X No
If yes, explain steps that will be taken to lessen
environmental impacts.
h. Will the placement of the proposed bridge or culvert
require any shoreline stabilization?
_ _Yes X No
If yes, explain in detail
NCDOT-Beaufort SR 1730
Applicant or Project Name
Signature
_ ()*, i, Q'��
Date 0 0-8/04
Revised 03/95
NORTH CAROLINA DEPARTMENT OF TRANSPO N n'- m
DIVISION OF HIGHWAYS
SR 1730
PIPE REPLACEMENT
JUL 0 2 2004
Morehe d City DC
BEAUFORT COUNTY
CAMA GENERAL PERMIT APPLICATION
DETAIL SHEET 1
,PLACE EXISTING 44'X24" CLARA M. NORMAN
R.C.P AND 46'x48" C.M.P. 352 LAKE ROAD
WITH TWO 46'X48" R.C.P. PANTEGO, NC 27860
DB/PG 868/422
,dl, all.
�I dl, b
AIL
dr, Ail.
R/W
404 WETLAND IMPACT: 0 SQ. FT.
COASTAL WETLAND IMPACT: 72 SQ. FT.
OPEN WATER IMPACT: 144 SQ. FT.
36 SQ. FT. COASTAL PAMLICO INVESTMENTS
IMPACTS c/o GRADY WHITE INC.
dl, r, PO BOX 1527
All — — dI, GREENVILLE, NC 27835
72 SQ. FT. OPEN
Lift -WATER IMPACTS
al,
2 Air, All.
a1. Alb all, — ,dc
�l II I I
I II I-------------------��
SHOULDER POINT ------------------------------------------
.r_rr_I 23 ------
__.
EDGE OF PAVEMENT
SR 1730 1 11 14 6'
I II I
EDGE OF PAVEMENT I7—
SHOULDERPOINT------------------------------------4-4H --------------------------------------
L II I
I
R/W -
--- r AEI � all.
_ I 72 SQ. FT. OPEN
36 SQ. FT. COASTAL all. NORMAL
} NORMAL WATER LEVEL uNE ll WATER IMPACTS
IMPACTS _ 1
A6, all,
CLAUDE J. WALTON Lill PEARL D. FOSTER
2286 AUTUMN DR. AII, c/o FRANCIS G. FOSTER
KINSTON, NC 28501 JI, 850 W. OLD PAMLICO BEACH ROAD
DB/PG 1246/419 ai w BELHAVEN. NC 27810
�
A, I � : All DB/PG 632/67
FINISHED EARTH SLOPE (3:1)
PROPOSED RIP RAP
(POSED
PIPE (2)
PIPE END DETAIL
NTS
NOTES:
U
all,
ILL
1�
d1.
II
' L
1) THIS PROJECT IS IN THE BATH TWP.
2) THIS PROJECT IS IN THE TAR—PAMLICO RIVER BASIN
3) THIS PROJECT DOES NOT FALL WITHIN ANY MUNICIPAL BOUNDARIES
4) PROJECT W IS 60'
5) ROAD NAME: PAMLICO BEACH ROAD
6) NO KNOWN NCGS MONUMENTS ON PROJECT
DRAWN BY. CHECKED BY: OWV04 1"=40'
AREA TO BE UNDISTURBED AREA
FILLED OR I I I11 111
DISTURBED IIIII11111 f111111i1
3Y.; Ntltlrrl
IIIII
FABRIC BURIED BELOW
EXISTING GRADE
SILT FENCE DETAIL
NTS
O R
'PIPE REPLACEMENTy�,—>
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
SR 1730 PRELIMINARY PLANS
PIPE REPLACEMENT ISO NOT USIs I,'OR CONSTRUCTION
BEAUFORT COUNTY
CAMA GENERAL PERMIT APPLICATION
DETAIL SHEET 2
ROAD SURFACE
AREA TO BE EXCAVATED AND BACKFILLED -- - - ►
NORMAL WATER LEVEL 4.0'
215' 215'
EXISTING 44'x24" R.C.P.
1.7'
2.5'
4.0' 0 4.0'
EXISTING 46'x48" C.M.P.
4.0'
3.8'
2.0' - 5.6'
6.6'
1 7.2'
EXISTING STREAM BED ��� 2' 2 ►�I \ I %%// I ,
UNDERCUT AND BACKFILL ----
EXCAVATION ABOVE NORMAL WATER LEVEL: 90 YD3
EXCAVATION BELOW NORMAL WATER LEVEL: 86 YD3
NOTES:
1) THIS PROJECT IS IN THE BATH TWP.
2) THIS PROJECT IS IN THE TAR—PAMLICO RIVER BASIN
3) THIS PROJECT DOES NOT FALL WITHIN ANY MUNICIPAL BOUNDARIES
4) PROJECT RV/ IS 60'
5) ROAD NAME: PAMLICO BEACH ROAD
6) NO KNOWN NCGS MONUMENTS ON PROJECT
DRAWN BY: CHECKED BY: OMI/04
DRB DIRT
16.5' -
PROPOSED 46'x48" ALUMINUM C.M.P. (2)
i
CERTIFIED MAIL
00RETURN RECEIPT REQUESTED
04/28/04
Pearl Foster
850 W. Old Pamlicon Beach Rd.
Belhaven NC 27810
Dear Ms. Foster,
This correspondence is to notify you as an adjacent riparian landowner that the North Carolina Department of Transportation
plans to replace the culvert adjacent to your property located on SR 1730 in Beaufort County. The sketch attached accurately
depicts the proposed construction.
Should you have objections to the proposed construction, please check the appropriate statement below, sign, date, and
return as soon as possible to:
Mr. Bill Arrington
N.C. Dept. of Environment and Natural Resources
Morehead City District
Division of Coastal Management
151-B Hwy 24 Hestron Plaza II
Morehead City, City N.C. 28557
Written comments must be received by the Division of Coastal Management within 10 days of receipt of this notice.
NO RESPONSE WITHIN 10 DAYS of receipt of the correspondence will be INTERPRETED AS NO OBJECTION.
Sincerely, I
I have no objection to the proposed project as described in this correspondence.
I have objection to the project as presently proposed and have enclosed comments.
(Signature)
(Date)
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
SR 1730
PIPE REPLACEMENT
BEAUFORT COUNTY
CAMA GENERAL PERMIT APPLICATION
PRELIMINARY PLANS DETAIL SHEET I
DO NOT USE FOR CONSTRUCTION
REPLACE EXISTING 44'x24"
R.C.P AND 46'x48" C.M.P.
WITH TWO 48'x48" R.C.P.
CLARA M.NORMAN
352 LAKE ROAD
PANTEGO, NC 27860
DB/PG 868/422
ah
All, all,
all. all, all,
all,
all,
2'
,III, ,Illy
all.
�P/W
SHOULDER POINT ------------
all.
all,
PAMLICO INVESTMENTS
c/o GRADY WHITE INC.
PO BOX 1527
GREENVILLE. NC 27835
a6,
alb
All,
----------------------------Ea�---------
EDGE OF PAVEMENT
SR 1730
Ilillll'
EDGE OF PAVEMENTti- —
SHOULDER POINT --------------------------------------- I------
404 WETLAND IMPACT: 0 SQ. FT. jk
COASTAL WETLAND IMPACT: 0 SQ. FT. all. _ —NORMAL WATER LEVEL LINE
OPEN WATER IMPACT: 0 SQ. FT.
CLAUDE J. WALTON all, a PEARL D. FOSTER
2286 AUTUMN DR. !' c/o FRANCIS G.FOSTER
KINSTON, NC 28501 r i,. 850 W. OLD PAMLICO BEACH ROAD
DB/PG 1246/419 BELHAVEN, NC 27810
�h 2' DB/PG 632/67
----------------------------Ea�---------
EDGE OF PAVEMENT
SR 1730
Ilillll'
EDGE OF PAVEMENTti- —
SHOULDER POINT --------------------------------------- I------
404 WETLAND IMPACT: 0 SQ. FT. jk
COASTAL WETLAND IMPACT: 0 SQ. FT. all. _ —NORMAL WATER LEVEL LINE
OPEN WATER IMPACT: 0 SQ. FT.
CLAUDE J. WALTON all, a PEARL D. FOSTER
2286 AUTUMN DR. !' c/o FRANCIS G.FOSTER
KINSTON, NC 28501 r i,. 850 W. OLD PAMLICO BEACH ROAD
DB/PG 1246/419 BELHAVEN, NC 27810
�h 2' DB/PG 632/67
r
o'
all.
1CL
1L
NOTES:
1) THIS PROJECT 15 IN THE BATH TWP.
2) THIS PROJECT IS IN THE TAR—PAMLICO RIVER BASIN
3) THIS PROJECT DOES NOT FALL WITHIN ANY MUNICIPAL BOUNDARIES
4)PROJECT RNJ IS 60'
5) ROAD NAME: PAMLICO BEACH ROAD
6) NO KNOWN NCGS MONUMENTS ON PROJECT
DRAWN BY: I CHECKED BY: 0323,04 1"=40'
AREA TO BE �1i1Cli '�� VNDL511JR9Ep AREA
FILLED
DISTURBEDol
.11':I IC IMI III IIIi Ii�
nln,
L
FABRIC: BURIED BELOW
EYISTING GRADE
SILT FENCE DETAIL
NTS
■ 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:
PAMLICO INVESTMENTS
In c/o GRADY WHITE, INCv.
P. O.BOX 1527 GREENVILLE, NC 2711jZQy�
0_ �J_c
A. Sign ure
X ❑Agent
❑ Addressee_
B. eceived by (Printed e) C. Date of Delive
2, e� el
iverV addresostifl j Yes
3. Service Type
V ��
YP U11,
O CertifiedC��jl, *dp
F:yti 1 1 Return Receipt for Merchandise
❑ I ured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
i (Transfer from service label) 7002 0 510 0000 6259 5383
PS Form 3811, August 2001 Domestic Return Receipt
UNITED STATES POSTAL SERVICE
a �
First -Class Mail
Postage &Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
NCDOT DIVISION OF HIGHWAYS
ATTN: JAY JOHNSON
P. O.BOX 1587
GREENVILLE, NC 27835-1587
17
1it'cEiie?i!?F�iS?{i??;3liF??{ti:{e�iii:ji3?i�??fit?3?i:?#?i
■ 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.
Article Addressed to:
MS. CLARA M. NORMAN
352 LAKE ROAD
PANTEGO, NC 27860
A. Signature �/� ,
X ��C�� ' ` l - ❑ Agent
Addressee
B. Received by (Printed Name) C.g ate of Deli/v/ery
/27
D. I `s Yes
if ente' el'SWE
o
JUL 0 2 2004
3. Service T& Q nn
CM
❑ Registered ❑ Return Receipt for Merchandise +
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
' (Transfer from service label) ? 0 0 2 0 510 0 0 0 0 6 2 5 9 5 3 9 0
PS Form 3811, August 2001 Domestic Return Receipt 2ACPRI-03-P-40811
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 •
NCDOT DIVISION OF HIGHWAYS
ATTN: JAY JOHNSON
P. O.BOX 1587
GREENVILLE, NC 27835-1587
M
J.,
■ 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.
A. Sigg�na��t jre
X
B. Received by (Printed
n
1. Article Addressed to: u Irs.aeuver
1f X1;S, e
MR. CLAUDE WALTON
2286 AUTUMN DRIVE
KINSTON, NC 28501
JUL 0 2 2004
❑ Agent
❑ Addressee
C. Date of Delivj�ry '
Ffi".ti -
RVAilald ySM
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
1 2. Article Number
(Transfer from service label) 7 0 0 2 0 510 0000 6259 5 3 7 6
PS Form 3811, August 2001 Domestic Return Receipt 2ACPRI-03-P-40e1i
UNITED STATES POSTAL SERVICE Scfirst-Class Mail
PostaUSPSge &Fees Paid
' Permit No\G-\0
• Sender: Please print your name, address, and ZIP+4 in this box •
NCDOT DIVISION OF HIGHWAYS S�z�N �pyJ
ATTN-. JAY JOHNSON
P. 0.BOX 1587
GREENVILLE, NC 27835-1587
■ 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:
MS. PEARL FOSTER
850 W. OLD PAMLICO BEACH RD.
BELHAVEN, NC 27810
COMPLETE THIS SECTION ON DELIVERY
A. Signature
X ❑Agent
❑ Addressee '
B. Received by (Printed Name) C. Date of Delivery
rp% re Tin PFF-M-EN
I - r o Yes
iif 1 � 2 delivery address No
in 0 2 2004
.Certified Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
(Transfer from service label) -+ c 0 51, 0 0 Q.0 0 6259 5406
PS Form 3811, August 2001 Domestic Return Receipt 2ACPRI-03-P-4081
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 •
NCDOT DIVISION OF HIGHWAYS
ATTN: JAY JOHNSON
P. O.BOX 1587
GREENVILLE, NC 27835-1587
1 '130
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
DIVISION OF HIGHWAYS
P. O. BOX 1 587
GREENVILLE, NORTH CAROLINA 27835-1 587
7002 05I0 0000 6259 5406
MS. PEARL FOSTER
850 W. OLD PAMLICO BEACH RD.
BELHAVEN,Iql§W
A 0 INSUFFICIENT ADDRESS
e IN
4 0f /7�4
POSIAGE •
42
11�I j. METE.
AME
Ist Notice
'end Notice
O� ATTEMPTED NOT KNOWN ❑ OTHER
rQ NO SUCH NUMBER/ STREET
OT DELIVERABLE AS ADDRESSED 70
UNABLE TO FORWARD
j i! ijtt yt S`• � 3 ! 1 !! 1 ' !! !