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HomeMy WebLinkAboutWO-02-15_Ball, John Richard_20150209 *' 7y¢#`f".€,a i rt st r p i f .L ?.. r r• ` 8.x J.1 XAI ,..,i s , F :4' i+" ;z�& 't 9 ` l-'r+ "S" t ", esw s ;'au ' r a"rl� 7�+t',`",t f src°r" i. "'z ", w„ :., r'Tr�. y ^r v'?"'. + # ✓% b vaC,:'..r r,; + � rs.�t t ri� M' i r � a �' �" ,J, �. '? ,r "' 4 ysryi a �.:} �4 a �.k. ror t ,L ? i # ". 7 k sMr ,D' ?� + 4 t �+' f,. m n ,C h s, X ''ar �.+"',,' a x a 4 '� '` r.�, 't h ....f, 7 � "k 6 fiz4 r W, k,, i' ;wr k x r k". i a w }#* K e'dft t' yip i¢`'�' n t T +'+ -"""' +,,. # t .a.'+ S �. i' y. a,r,a'..jS+a' `fir a .w, .� z p tt f.¢�,r�"'�,, :+ e F 1�1 t r `8 r` ap,� 14 V "" xr ^Nr' '¢xx» ,! `* ' ,�S snr' m i'ke + iH.''!" x a- 19 t n 'J € w+'1 rW r W t "Rr "Nd 44 r �,y -a+ ,,_. +« r •F .?. .k , a �i... 3 r g}nf, €w 5#>N a , u" cacaM' a,- ',•.y'v iiwi Yk€ .,Da rb . er':. '� a �€.„^,h.., rr �! ,k m k x,:.i: D' 4hw . y w( }y _ 4 "�` ) ,{ l.♦ s� THY , 5�� �p j� .•u yF ¢o :Y33��;;'j Wilt ' i' . �;"� ',.F;. _'i ".".', "i:q� * ^,AMA 4'. 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' ..s. :,r ! t"':.:.�YY�.!, '.•k� �r ,.,. -r, .r}.�?.,�s.�:.Y �.y.. r. jr,r.,,r. L,,., r F?R.,,4�, .,� ,,.e_a'€c 1. ;k C^'S.«. r+'€'io `:,A ,t` :::,M' r �j .> „ ;':7k 5a,.....�r. ,..,F."'3'i..: i k .,X .:., 7� �,�(..,.,Pnr"Y'!?��.,r(f9YySC�.sr en✓,��i }. '� A.,4;T`d k+. :f'„ €,r t �i .ah ti, ._ ::,u#. • *, :a,�t x. �,' ;. r u'° E�! j�Q�A'fSp;.p [yvgJ trrt :d. , . R, n €,,,, w' ua i? "+yr r'd,^ .5:-'" _ , o F.w'#f`. # ' `, s,. .s. ".Tw :? y: ru ,. •J/ sv.. �v ¢ 4 f + t% tk ,fi t' .y, +, ra "�t�y ,k tRa i � ., xt' D'i <� }w �` ai. 1 v a a€° i. s.r�,��wa'�� a Sw ai.,suer. '� w w, ,w ur * �r,€ s , ti��,.. ,, L 11- i 4 '�, % k, GENERAL 'INFORM fTION '€ w, k I;AND gwKklk ;s r ,_tI Name (7�'lt i`�1G1�'G1.� J- Address` 2 LO -` (�G �� 4 l'1��j C,St�-"S ' ! t 1 `'. t �:.t ` .. ' .f 1 3Ti`2��{ City��LG1�C�II`1 State C.. Zip1��y Phone r` Z L 'J, � ' •, ,.r + a .° , ,, t' Email ' Q �'_ % 1 }' t AUTHORIZED AGEnnNT ' , ' Name :pe�1�a K-1 '._=,, 1�1 .i i'l.l6��.(~F' °_ , `' Address • CC, 1. �G?' c .i t w i F '. .... . .r, x. , ,, n .-rs � .+Y .,. ,', , i. City',CiYIQ�d 1lState ' Zip qt# Phone 2L' �G`J� U2.Co� t Email +f �Ck6GEC �l� 1 €D( � %�C�C�Y t t ie 7 L{)CATION OF=PROJECT. (Addtess; strm dC rti etwt�ns to site If not oceanfront, what is the name ofthe' ` adjacent waterbody) ° ; ? � ", K DESCRIPTIQN OFFPROJEGT j(List all}proposed construction and land disturbance) (�1(1 a Ufl� 6iUCU� <. a t t� , aC € r x >. ,4 F ,u y �, r a! - 4 t # , i ak SIZE QF LOT/PARCEL ` I ��� ` square feet ` acres • w .11 ¢ 3 a Y F '1 f x' , F k % w r t p a r i .'¢ '� F y 3'� �` b " } 4 3 ? PROPOSED€iJ5E''ResidOWil µ, (angle family` tMulti family 0) CamznerciaiAndustrial <Other Ok hr 3 " r rr ? 4.?b p i -y. $r ' a: t L tia# x a S# ¢ y t t r�%t 1 :. : , ? $ r : ~F`� r, Y.'ta � Y i n yt d, ,, Y f ,.' d,, zr €' a r-: + ? p t r. COIV PLETE ETHER (1)€OR (2) BELOW (Conta'ct your Local Permit OJ�cer°if you are not sure wh MAEC applies to your prdperty)e t> r r , '* fy i w a r `- i V 1. 1 `4 - t Y t - 4 S ' ( { A # J 4 ;€ 6)' I - HAZARp,AECs. TOTALFLQOR'AREA OFPROPOSED STR1lCTiTRE: square feet (includes, ':. f ( f : 4 9 ° J ', 4 , �', Y ,E� .• £ 3 N ; a .,,. k ' .' r ,€ " ^ 9 S, ii't , air conditioned living space, parking elevated abo.,e ound level; non conditioned s ace elevatedrabove round level tier , w 8r p g §^ ^. h E f}4 ! 4 r 4 i. �' F J ">w A{ 3a,e A : } # 4 hw 3 S r 4 - x, ,," ing_non load bearing attic space) i' Y hr t A 3 k ;� °j' { ' ,.. €S ! ��, T , 3', f� } y� a r w + a f ,. 3 i 3 r i r, K? r , k q. y rt p 4. k < y a k.'. `ks * e t5 s# -j.€ w r k r' "m k 4 r Ta "€ U " ,' r , /€ t^ ?, ! 1` to c, i. I 4 (2)' COASTAI�SHORELINE-AECs:' SIZE OF BUILDING FQOTPRINT ANDiOTHER IMPERVIOUS'OR'BUILT s ,' t ;,- �, m Y UPON 5iJRFACES square feet (rneludes the area othe roof/tirxp line ofallkbuild�ngs, driueways,covered decks; yconcrete vr,masontyjpatias, etc ;that are within the applicable AEC Attach your calculations?with thaproject drawtng ) r ;, M Z, 6 {tea d v }. i 4 T T 1t 1 R € 4 ?'?, .! ." !? r "d€.a Y y s t '�' '" ''v '7 .`r °� t ,'`+, s t f'•.ka try ., ` D STATE STORMWATER MANAGEMENT FE161T Is the project loc`ated'in an area subject tq a State S' imwate '' �M� anagem6fit�Ptde tt Issued by the NC Division of Water Quality? k' ' ,, "f g t €"A 6I ESr t f.1yO�` ;,€"r, rl a� p 1 - y ; v �F `` r tf v r -, { � ,K y k { #�, f. ? z:.. y, �t }x��".T"t +v ' h < + {ki 7. `t' 3 ,, r3 A5 .P i ` S ¢ R p'F ,� Ifyes,"•list;the,tota(built-upon;area it ervious'surfaceallQwednfor ourlot,or itc 1, " ..� -' �.`s'' uaref0 — F t p" t p a M Y P q k, g s+#,,:{' r ¢'s# w g psc + �, `� +.. W ', ?�. o- f `r.+ v ?, r w, #r a ! € �, +-gym Sk 0 !fi e m + s i ¢, * � e + a , } r € y y ¢ ?r� 3 r'"W'L '- <r T t- o x° A r i" 4 , s 4i e_ ?r a a '^> r » a Ty't, -v: e k , �,! P. it7 �Sr t r , ¢ r s3. # xh 4, z t r. t t ' rf» I. J b. #€`SiW+3 Faws 3 ' Y f 4 e kus .� J=; x + + # ! a,8 '*ar a q 4 F u' .rye e,{ 'h' rr57, a ae £...� s a s + r ,+.��}?,'; f zx.q' `" `^�+ + t rt ,fr> a 3k ,r + r €i € § f ! # #" ¢ it D; C,, u{+ 1 p ,i' ..y3' €� ° t 'Y IaE :.' .t"# 'tv t 5a , z p+k" " { t ,, itps! +fir, "'lll"t R� F 3 t fit..{ , "k's `£ r'�� w¢` .. t . *ik #' } 5 .. '�e. i � rfi tir k i ' t zdy --1 �, y�r t ti s'� r f :..,, r + x Ri;. t .$3- _' ,r > C 5 r'v ^t .: ks'-7 'Yi a F '`S i ! F! �' ,Sr ^" a q f 7 A t 1 5 €; t# { X a x tl t, J V i ! A € .e, $$t�`k, g ,:w.wk L. .:,,_. itkw •_4_,ai;- ,� >`. a D': # r +-f' t €i r•%--'. +'.«y „a. Y,. ^ # .+` .� ::f x. '.,+�,. < s'r. , y...,a, xt,u `irtE'ac.t,-.5:, ..s€ .r,<:.;°m,,,*T' #.s.a+,r,f.� w. r .v .. : ti. •%.,., , a,. .,. ..,.,eo' .s. , ! r ...; a . .ad 2M.r,_.. :, ..,_ a,__, ,:: I(Coard Method) so NC Hwy. 24 ------------ lntrocooatal Waterway VICINITY MAP —NOT TO SCALE +ear U 1 w 0 an 40 1 4� 2g 6 wn V79100puW. FVA91 VIIIV R/W - Right. - of Way ' '. Courses a Distance* Along Aaaroxinate Man Mob natar Line snaring Distance N S 79.17.46• Q 64.97' 8 77.42.16• !f 34.BD• S TS•02'43•. / S 72'O3•59 V 2U083' • - • •. :: ' ... Ta; . � . gyps NOTE Nan_Wnmrmted Man' do .tf:.Tl» Sopthrest Coarser Comers Along Approximate Mean of Lot 20 NO Water tine Of Cmd (&cept . As Labeled). See TaNe Above. &z. ho tz3 :.t moa- 1� Dock +dl , Ramp as 18 tilde%i on '� �„• fttat t'wrly 19 �p -;15* c t'rre zAs• i c' ,tip »%5r, NOM. Set Nar7 G7 *rmnf Right Z Dockteva a At 9J0' UponSea .3ra� :'•• 4 Cedor Pofnt ZmAng - R20 EWs"_ .. NO1E CAM SetbacklAW Ltna RAryPr Town Of Cdor Pant do G3SSpy NQtrlde,rut County �KK q�o z (ttyo` ro•j �c (R/WA 'low- Is Located In a flood Zone j Per Torn '1 75'11'58 t3oist4rg of Cedor Pq&tt RORA J70M 5374 K $� `}— A trapPipe, Efleam a 11--J-0 ' � IAlbn-nt Ofate rated Comer R.EFNRNNCE: Lot 18 TOLPHIN BUY ESTATES' Map Book 12 Page 88 E.* ng Carteret County Registry kog naa I /DOLPHI /N BAY ESTATES GRAPHIC SCALE -- FEET t Cc^AIifY T?3tT tsxs W I= AUM UJ01[]r MY pii lo-14 ' P,'sical Lot r�urvef+' For: MoNaLF StARVeY auoE LWDIDttiUf: R£L�YED W� nurNor�l®1L711�Y RICHARD BALL txusH rRmr wt�uu7latr nr a,,snY , awr — ow em" ocrmcwc, January 26, 2015 Jan Dekleuver 128 Dolphin Bay Estates Cedar Point NC 28584 Dear Adjacent Property, The letter is to inform you that I, Dr. John Ball have applied for a CAMA Minor Permit on my property at 126 Dolphin Bay Estates., in Carteret County. As required by CAMA regulations, I have a copy of my permit application and a project drawing as notification of my proposed project. No action is required from you. If you have any questions or comments about my proposed project, please contact me at 919 427 6549, or by mail at the address listed below. If you wish to file comments or objections with the Town of Cedar Point CAMA Minor Program, you may submit them to: Local Permit Officer Town of Emerald Isle 7500 Emerald Dr Emerald Isle NC 28594 Sincerely Dr. John Ball 202 Three Oaks Ct Swansboro NC 28584 January 26, 2015 Larry Denning 1101 Clifton Rd Jacksonville NC 28540 + Dear Adjacent Property, The letter is to inform you that I, Dr. John Ball have applied for a CAMA Minor Permit on my property at 126 Dolphin Bay Estates., in Carteret County. As required by CAMA regulations, I have a copy of my permit application and a project drawing as notification of my proposed project. No action is required from you. If you have any questions or comments about my proposed project, please contact me at 919 427 6549, or by mail at the address listed below. If you wish to file comments or objections with the Town of Cedar Point CAMA Minor Program, you may submit them to: Local Permit Officer Town of Emerald Isle 7500 Emerald Dr Emerald Isle NC 28594 Sincerely Dr. John Ball 202 Three Oaks Ct Swansboro NC 28584 c ao 126 Dolphin Bay Estates Cedar Point, NC Front Deck Expansion/Enclosure Pile/Girder — Deck/Floor Framing 24'-0" 11'4r Existing house Existing Front Wall — to be removed 8 X 8 — typ• HUC212-2 h— HUC212-2 typ N N XIN Is 2 X 10 oots a 16" old New8X8 New8X8 X .N-. New8X8 2 X 10 JOLIAS Q 18" c1c Existing e X 6 to remain - typ x N tV v iojolsti under roof support plies above New6X6 - (2)2X12s New6X6 (2)2X12S New6X6 Notes: 1) Dimenslons are approximate. All construction to be per North Carolina State Residential Building Code (NCRBC), 2012 Edition. Remove existing deck framing and existing covered porch roof. Expand living area to the front by 4'. 2) Attach girders to posts with (2) 60 thru bolts. Where posts are notched greater than 50% provide PS218 strap with (4) 518" thru bolts. At comer notched plies provide (2) PS218 straps — one each way. 3) Attach joists to girders with LUS26.2 hangers and provide a 2 X 2 ledger beneath joists. 4) New posts may be set in 3' wide X 4' deep hole filled with concrete OR buried a min of 8 feet. Provide two 16" long 818" rebars (one each way) thru the posts at 6" above the bottom if using concrete. 5)Englneer's seal on documents applies only to structural components. Seal does not Include construction means, methods, techniques, sequences, procedures, or safety precautions. Flashing and waterproofing by others. Any deviations or discrepancies on plans are to be brought to the immediate attention to Engineer. Failure to do so will void Engineer's liability. Seal ls valid for projects permitted one year from date of seal. House expansion area. New piles, girders, floor framing, 2 X 4 stud wails, and rod trusses to match existing. N Provide new truss, In place of existing N gable end wag before removing existing front wag X N is Sheet 1 of 3 1/4" =1' File # 2015 - 010 Ken Lacy, P.E. PLLC P0344 307 Holly Lane Cape Carteret, NC 28584 252-725 2405 11 126 Dolphin Bay Estates Cedar Point, NC Front Deck Expansion/Enclosure Roof Framing i 24'-W t.� a New front expansion area m New Roof Over House Expansion 2 X 8 Rafters New 8 X 8 porch and ceiling joists roof posts - typ Is- c/o (2) 2 X 10 Roof Girders New P Roof Notes: 1) Dimensions are approximate. All construction to be per North Carolina State Residential Building Code (NCRBC), 2012 Edition. 2) Roof girder to pile notching per NCRBC, 20i2 Edition. Attach posts to roof girder with PS218 Straps and (4) 6/8" thru bolts. Exact height of new roof girder to be field determined to work with existing overhangs and soffits. Roof trusses to match existing. Roof trusses by others. 3) Attach rafters and trusses to girders and walls with ti10A ties. Attach hips to girders with MTS12 Straps 4) Attach porch roof support posts to double Joists below with (2) MT812 Straps. Attach notched posts to porch roof girder with PS219 straps and (4) 518" thru bolts. New roof trusses to match exMng I Ih -••A-- T `` (� ' 1��� Sheet 2 of 3 1/4" =1' File # 2015 - 010 Ken Lacy, P.E. PLLC P0344 307 Holly Lane Cape Carteret, NC 28584 252-725-2405 126 Dolphin Bay Estates Cedar Point, NC Deck Expanslon/Enclosure H10A Tie (4) 5/8" thru bolt< osts provide(2) ps, one each 5/8'thru bolts. is provide p w/(4) 8/8'thru New Porch Roof Girder Not to Scale GROUND FLOOR WALL ENCLOSURE BETWEEN PILES It Is proposed to enclose between the existing support piles on the ground floor to form an enclosed area. An existing 4' concrete slab is In place at the ground level. The existing 2X girders running between the posts and the 2X joists appear to be In good shape. Since the main vertical support is provided by the existing house girders and piles,.the wall enclosures will be basically non - load bearing. The 4' concrete slab is adequate to support the new wall framing and to provide lateral resistance perpendicular to the walls. To support the new wall framing and to provide lateral resistance, provide the following: - Provide 2 X 4 studs at 16' o/c with a double base plate and a single top plate. - Provide W plywood or OSB sheathing along with the siding of choice. - Attach the base plates to the existing concrete with 5/8' wedge anchors. Provide three (3) between the piles with two (2) being within 1' of the plies and comers. Wedge anchors shall penetrate concrete 2'. - Provide a 2 X 4 stud against each pile and attach to the pile with (2)16d nails at 12' o/c. - Attach the top plate to the existing girders with (2)18d nails at 12' c/o. PS218 Strap Typical Pile Splice Not to Scale ?y f 44 fllrrllilt►tj� t�1�� ,I 1 Sheet 3 of 3 1/4" =1' File # 2015 - 010 Ken Lacy. P.E. PLLC.P0344 307 Holly Lane Cape Carteret, NC 28584 252-725-2405 Course Bearing Distance Lt S 79'17'48" W 64.97' L2 S 77°42'16' W 54.80' L3 S 75"02'43" W 15.74' --------- C A N A Ii S 7703'59 W200.83• Intracoastal Waterway ToExistingIron Pipe NOTE.• Non-Monumented Lines & At The Southwest Comer Corners Along ApproximateMean Of Lot 20 High Water Line Of Canal (Except VICINITY MAP -NOT TO SCALE As Labeled). See Table Above. .5 4' rZ N f, I• ` 12.3' 1 uMv - tl+ 11 L2 hd Dock ZI Existing L3 Iron Pip a �: �------ ' "`" Existing 14, 215 Sq. Ft. oat' z Iron Pipe 4 ti O �O Ln u 17 ,. qj �04 NOTE.• Set Nail In Front Right Deck Piling At 9.30' Mean Sea Level (NAVD 1988) Cedar Point Zoning - R20 NOTE.• CAMA Setback/AEC Line Per Town Of Cedar Point & 1 (Coord. Method) Roof 18.6' Overhang _ . Storage N Shod b 1 N 8.2' m e Overhang,.p n C5 75- AE•C `C Line @ LL`r I 30' CAMA Buffer Rof o; ,_ -••. Ic � Overhang J "� �' $ ($ One Story • b . ., o Dwelling On h Pilings 14 w 2 6 x 2 6 g i Heat , Pump t� ^ l 9 ,I Y• SC%Vrd � ��J ., Dec _ bpen7)ecr�' - ^ • �lfn B � • � o � ';n'; p � Existing a lit�P BOX Iron Pipe v Rao, . .9 0�� Carteret County / S S� ?j, , water ti .0 O .d Z SS 8¢Ss. O valveNOTE., Property Is Located In ro 86��Ch 0• `. 40.00' (R/W) Flood Zone AE (9.3) Per Town -1►U1 J N 75'11'561E TExisting Of Cedar Point FIRM 370465 5374 K �� �— Metero Iron Pipe Effective I 1-J-05 .00� g� P ' o, NOTE: Non-Monumented Comer REFERENCE: At Point, Of Curve Lot 18 "DOLPHIN BAY ESTATES" Map Book 12 Page 86 Existing Carteret County Registry Mag. Non DOLPHIN BAY ESTATES (60' Public R/W) 30 0 30 60 90 Revised 1-26-15 (Compute Impervious Area) GRAPHIC SCALE — FEET Carteret Countv WO.03.15 Local Government Permit Number CAMA MINOR DEVELOPMENT PERMIT as authorized by the State of North Carolina, Department of Environment, and Natural Resources and the Coastal Resources Commission for development in an area of environment concern pursuant to Section 113A-118 of the General Statutes, "Coastal Area Management" Issued to Faye Aman, authorizing development in the Estuarine Shoreline - ORW (AEC) at 130 Sunset Drive, in Cedar Point, NC, as requested in the permittee's application, dated 02/11/15. This permit, issued on 02/24/15, is subject to compliance with the application and site drawing (where consistent with the permit), all applicable regulations and special conditions and notes set forth below. Any violation of these terms may subject permittee to a fine, imprisonment or civil action, or may cause the permit to be null and void. This permit authorizes: Construction of single-family dwelling, removal of tree stumps, and minor grading (1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s) dated received on 02/12115. (2) All construction must conform to the N.C. Building Code requirements and all other local, State and Federal regulations, applicable local ordinances and FEMA Flood Regulations. (3) Any change or changes in the plans for development, construction, or land use activities will require a re-evaluation and modification of this permit. (4) A copy of this permit shall be posted or available on site. Contact this office at 252-222-5833 for a final inspection at completion of work. (Additional Permit Conditions on Page 2) This permit action may be appealed by the permittee or other qualified persons within twenty (20) days of the issuing date. This permit must be on the project site and accessible to the permit officer when the project is inspected for compliance. Any maintenance work or project modification not covered under this permit, require further written permit approval. All work must cease when this permit expires on: DECEMBER 31, 2018 In issuing this permit it is agreed that this project is consistent with the local Land Use Plan and all applicable ordinances. This permit may not be transferred to another party without the written approval of the Division of Coastal Management. r -- Dean Lombreglia CAMA LOCAL PERMIT OFFICIAL 701 Cedar Point Blvd Cedar Point, NC 28584 PERMITTEE (Signature required if conditions above apply to permit) Name: Faye Aman Minor Permit # WO.03.15 Date: 02/24/2015 Page 2 (5) The amount of impervious surface shall not exceed .25% of the lot area within 575 feet of Normal High Water (Estuarine Shoreline - ORW Area of Environmental Concem), in this case, 2,902 square feet is authorized. (6) Unless specifically allowed in 15A NCAC 07H. 0209(d)(10), and shown on the permitted plan drawing, all development/construction shall be located a distance of 30 feet landward of Normal High Water. No portion of the roof overhang shall encroach into the 30 ft. buffer. (7) All unconsolidated material resulting from associated grading and landscaping shall be retained on site by effective sedimentation and erosion control measures. Prior to any land -disturbing activities, a barrier line of filter cloth must be installed between the land disturbing activity and the adjacent marsh or.water areas, until such time as the area has been properly stabilized with a vegetative cover. (8) Any proposed for grading within the 30' buffer from the Normal High Water must be contoured to prevent additional stormwater runoff to the adjacent marsh. This area shall be immediately vegetatively stabilized, and must remain in a vegetated state. (9) All other disturbed areas shall be vegetatively stabilized (planted and mulched) within 14 days of construction completion. SIGNATURE: DATE: PERMITTEE odpr r%,►Q 1 is planned for an )ast )r purpose of filing 'a CAMA permit application nj, a site drawing as described on the back of this application, the ,re necessary, a checkfor $100.00 made payable to the locality, and 2nt. The details of the application as described by these sources are be issued. Deviation from these details will constitute a violation of 3 'III l tie Mike&Cynthia Powell i ir-6 "T'�T"'T•�� tt 4 GARAGE I Ir-r x 23W _" it' f oast nn;tn uwa uc k _ r t Rai! ',Fence 3' wood I . 23, 922 Sq: Ft. Rail Fence - Oar ,. Set Iron ' Stake, 1.5AG 36�36 „W (Con trot) 9 3 o45 t Boathouse t 4, B 0 G U E S o t y a Y I v Pier _ n &f proxrma a o0 , ,rCedar Point.;P-RM' "'Map No..3721 Effective 11-3- 05 Zone VE (12) Existing Iron Rod with r Concrete Monument Guard a „A A B�. Course Bey' L 1 S 8V52 L2 S - 721 - L3 S 16'2 L4 S .532. L5 N.'8I*JJ .e � ii��IET€{�:6zi;;s{lDor � 4 Poster 5 #Q,4 t758� m ru Certitted Fee #3.30 0 O OO Return Rewpt Fee (Endorsement Required) (? , ];1 Postmark Here C3 Rusnii.od Dollvwy Fee (EnuorsemomRequVed) RJ O m Total Postage & Fees •� . {S t ?Ji i J2lii ''pa 'a nt O (- Or PO BOX No. ryt. :rr r.