43291D - Johnson

- AMA+/ DREDGE & FILL e.,. ....____
ENERAL PERMIT Previous permit#
'New -Modification LComplete Reissue liPartial Reissue Date previous permit issued
.rized by the State of North Carolina, Department of Environment and Natural Resources u
Coastal Resources Commission in an area of environmental concern pursuant to 15A NCAC P7 . Q.0
[Rules attached.
At Name J'LHS0'7 Project Location: County 11/Gtiv / s+fitte''
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0V 03 2005 11 : 14AM p,
CAMA AND DREDGE AND FILL
GENERAL
PERMIT 5734-t
tO as authorized by the State of North Carolina,
Department of Natural Resources and Community Developmez d the Coastal Resources Commission
in an area of environmental concern pursuant to 15 NC.AC_ "! •i-)(Y)
Iplicant a J ill l's); FiZadigir Phone Number /7 gq "5��/a
(dress gip. OQmf n/8 1-72 • fj�}
ty State r 1�() - Zip ,�CY 15 4(7)4
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t Locati n (County, tate R ater Body,etc.
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pe of Project Activity I [&'t i r)C lG
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PROJECT DESCRIPTION SKETCH ` 4 >4 5' t (SCALE: "/'
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cubic yards7 , /
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its permit is subject to compliance with this application, site / f
awing and attached general and specific conditions. Any / r r J
olation of these terms may subject the permittee to a fine,
iprisonment or civil action; and may cause the permit to be- Ik':57 iunt'ssh
►ale null and void. j....
its permit must be on the project site and accessible to theI i
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OMPLETE THIS SECTION COAIPLETE THIS SECTION ON bEUVERY
Items 1,2, and 3.Also complete A. signature
ios'ricted De,lvery is desired. X ❑Agent
name and address on the reverse _�j - 0 Addressee
D Can return the card to you,
s card to the back of the meilpiece, - - C. Date of Delivery
!rent if space permits. _ S
99sed to b, Is delivery Address different from Rem 1' 0 Yes
•gee If YES,onter delivery Address below: 0 No
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3. Service Type
`,1 YII If fed Mail ❑ Express Mall
❑ Registered d Return Receipt fo Merchandise
In Insured Mail 0 C.O.D.
4. Restricted Delivery?(Extra Pea) ❑Yos
70•
042890 0002 6955 9367
n service IOboQ
1,Febr.lary 2004 Domestic Return Receipt
10259:oa.-na-1540
PLETE THIS SECTION COMPRETE THIS SECTION ON bt:L1VERV
ms 1, 2.and 3.Also complete ^•n.t
:rued Delivery is desired.
me and address on the reverse � � �� r• ❑Agent
to return the card to you. — • 1 Addresaeo
trd to the back of the mailplece, �4 Date of rivery
it If space permits. 12
D, Is de11v ^�?Prf to' ery address different from Rom 1? ■ Yes
If YES,enter delivery address below! ❑No
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❑ Registered 0 Return Receipt for Merchandise
0 Insured Mail 0 C.O.J.
4, Restricted boliveyj(arra Fee)
❑ YAs
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7004 2890 0002 6955 9374
--•
Domestic Return Receipt 45
f029 -02-M.1540

ROGER JOHNSON 8528
CATHY JOHNSON
• PH 686-0302
1931 TURNER NURSERY RD /�) _ - _� — 86-7172/2531
WILMINGTON,NC 28405 /�Y �,
oI PAY TO / / DATE
ZS ORDER OFE�Y $ d
ROI I BRS
COOPERATIVE Ls-Limp BANKING
WILMINGTON,NC
1: 253 L7 L7 281: L60004550311' 0 '28

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RECEIVED
JAN 0 9 2006
JENNIFER L. UMBAUGH BY:
Attorney At Law
Mailing Address:
7232 Wrightsville Avenue P.O.Box 1100
Wilmington,NC 28403 Wrightsville Beach,NC 28480
E-mail: Jumbaugh(abellsouth.net [phone](Tel)
[phone](Fax)
January9, 2006 RECEIVED
DCM WILMINGTON, NC
Mr. Robb Mair JAN 0 9 2006
Coastal Management
Field Representation Division
127 Cardinal Drive, Extension
Wilmington, N.C. 28405 VIA HAND DELIVERY
Re:Pier Permit Application Submitted by Jeff Johnson,317 Pages Creek Drive,Wilmington
Dear Mr. Mair:
Thank you for taking the time to speak with me today. As you know,I am the owner of 7456
Dunbar Road, Wilmington, N.C. which is the property located immediately to the west of Mr.
Johnson's lot. This will confirm that I have never received any notification from Mr. Johnson
relating to his intent to seek a CAMA permit to construct a pier across the cove which is directly in
front of my property. I did receive a memorandum dated January 2, 2006 on January 9, 2006 from
Buck O'Shields,the prior owner of my property stating Mr.Johnson had applied for a CAMA permit
to construct a pier, boat lift, covered deck and floating pier along with a waiver form, a drawing of
the proposed Johnson pier, and two maps (one indicating a pier line).
As we discussed today, I strenuously object to Mr. Johnson's proposal and request to
construct the pier,boat lift,covered deck and floating pier. Prior to Mr. Shield's letter of last week,
I was never made aware of any agreement Mr. Shields had made with the prior owner of Mr.
Johnson's lot concerning any riparian corridor nor was I never made aware of the map denoting a
pier line. I am enclosing the Deed to my property, which you will see makes no reference to any
waiver of riparian rights or any agreement to waive any such rights.
I understand from our conversation of today, that Mr. Johnson had already been issued a
CAMA permit but that you will be suspending that permit. It is further my understanding that until

Mr. Robb Mair
January 9, 2006
page two
Thank you for your consideration of my concerns.
incerely/
e er L. U gh
cc: Mr. Jeff Johnson c/o Johnson Marine
Mr. Buck O'Shields
RECEIVED
DCM WILMINGTON, NC
JAN 0 9 2006

``IIIIIIII III�IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII
•
IIIIIIIIIIIIII
2004055363
FOR REGISTRATION REGISTER OF DEEDS
REBECCA T. CHRISTIAN
NEW HANOVER COUNTY, NC
2004 0CT 18 10:03:22 AM
BK:4531 PG:363-366 FEE:$20.00
NC REV STAMP:$1,050.00
INSTRUMENT # 20a4055363
ED
DCM WILMINGTON, NC
!AN 0 9 2006
NORTH CAROLINA GENERAL WARRANTY DEED
ise Tax: $ 1,050.00
:el Identifier No.R04505-008-017-000 Verified by County on the day of , 20_
RETURN TO
UBox to: Grantee CTTEVEN F. GEL
[phone]
;instrument was prepared by: Fuss&Fairley,Attorneys-without title examination
;f description for the Index: LT 1 OBR, PH 3, DUNBAR LANDING
iS DEED made this/Oday of bbar-e_ ,2Op 4by and between
GRANTOR GRANTEE
id O'Shields,Jr. and wife, Jennifer Leigh Umbaugh
y A. O'Shields 7456 Dunbar Road
Wilmington,NC 28411
designation Grantor and Grantee as used herein shall include said parties,their heirs,successors,and assigns,and shall include
;War,plural,masculine,feminine or neuter as required by context.
INESSETH,that the Grantor,for a valuable consideration paid by the Grantee,the receipt of which is hereby acknowledged,has
by these presents does grant,bargain,sell and convey unto the Grantee in fee simple,all that certain lot or parcel of land situated
le City of Wilmington ,- Township, New Hanover County,North Carolina anc
re particularly described as follows:
attachement for legal description.

)HAVE AND TO HOLD the aforesaid lot or parcel of land and all privileges and appurtenances thereto belonging to the Grantee
fee simple.
.d the Grantor covenants with the Grantee,that Grantor is seized of the premises in fee simple,has the right to convey the same ii
simple,that title is marketable and free and clear of all encumbrances,and that Grantor will warrant and defend the title agains
lawful claims of all persons whomsoever,other than the following exceptions: easements and restrictions of record; 2004
valorem taxes
IN WITNESS WHEREOF,the Grantor has duly executed the fore oing as of the da . `. year st above written.
I//t /.
(SEAL)
(Entity Name) Claud O'Shie ds,Jr.
. '.-I i.,„..k., a. 6-dvite.e, (SEAL)
Title: J(idy A. O'Sl fields
(SEAL)
Title:
(SEAL)
Title:
to of North Carolina-County of New Hanover
I, the undersigned Notary Public of the County and State aforesaid, certify that Claud O'Shields,Jr. and wife,Judy A.
Shields personally appeared before me this day and
nowledged the due execution of the foregoing instrument for the purpos therein expressed. Witness my hand and Notarial
op or seal this \I-4 day of ©C -o 1A,A, ,20 C i
•
Commission Expires: (}3'2c. ,_r "-` OFFICIAL SEALI� Z ,
' ' Notary Public,Nortl i Ca1Yu i-
°:_t 1 County of Penaer 'tart'Public
.,. NANETTE F.JONES
:e of North Carolina-County of
I,the undersigned Notary Public of the County and State aforesaid,certify that
tonally came before me this day and acknowledged that_he is the of
, a North Carolina or
corporation/limited liability company/general partnership/limited partnership(strike through the inapplicable),and
by authority duly given and as the act of such entity,_he signed the foregoing instrument in its name on its behalf as its act and
i. Witness my hand and Notarial stamp or seal,this day of , 20 .
Commission Expires:
Notary Public
e of North Carolina-County of
I,the undersigned Notary Public of the County and State aforesaid,certify that
ness my hand and Notarial stamp or seal,this day of ,20 .
Commission Expires: R E C E i V E D
Notary Public DCM WILMINGTON NC

• ,
•
•
Exhibit"A"
3 all of Lot 10BR, as shown on a map recorded in Map Book 46 at Page 347 of the New Hanover Coun
ry, (being the same lot as 10R, Phase III of Dunbar Landing as shown at map Book 32 at Page 390)
ice to which is hereby made for a more particular description.
ACT to the Drainage and Sight Easement in favor of Lot 8BR as shown on the map recorded at Map
46 at Page 347 of the New Hanover County Registry and as described with more particularity as follow
•ainage easement shown on a Map of Revision recorded in Map Book 46 at Page 347 shall run with the
nd is a part of the originally designed natural drainage system for Phase III of Dunbar Landing. The
(s) of Lot 10BR shall agree and understand that surface water runoff from adjacent lots within Dunbar
zg may at time collect within this easement and be held there until such times as ground absorption
;. The intent is to prevent the run off from going directly into Pages Creek. The owner(s) of Lot 10BR
nake no changes within the easement that limits this occurrence.
to easement bring that same area as the drainage easement and shown in Map Book 46 at page 347 sha]
;th the land and be as follows: All plants either planted by the owner(s) or other on Lot 10BR within the
Lent area and or allowed to volunteer within said easement shall be kept to a maximum height of 4 feet.
hall include any natural vegetation along said high water line adjacent to the creek and within the area
xl to be maintained under existing regulations.
owner(s) of Lot 8BR, Phase III Dunbar Landing believe the height restrictions are being exceeded they
itify the owners of Lot 10BR of their concern and ask that steps be taken to bring the plat or plants or
nto compliance. If the owner(s) of Lot 10BR fails to take action within 30 days, the owner(s) of Lot 81
iotify the owner(s) of Lot 10BR by certified mail of their intent to enter the easement area and as
tied on the map and trim the plants, etc, accordingly. The owner(s) of Lot 10BR shall hold the owner(s
8BR harmless for this action.
asement granted to the owner(s) of Lot 8BR shall not be used for purposes other than those set forth he
•e to act by owner(s) of Lot 8BR as to the rights contained shall not be deemed a waiver of said rights.
owner(s) of Lot 10BR fail to comply with the restrictions set forth, the owner(s) of Lot 8BR may seek
rtion for costs involved in correcting the violations if it is determined that failure to comply is willful.
monetary compensation granted by the court can be placed as a lien on Lot 10BR if not paid within 30
and said lien shall remain until paid or the property is sold.
easements shall be deemed covenants running with the land and shall be binding on the heirs, success;

. otirovv? o&
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\\....„........,
0014
REBECCA T. CHRISTIAN
REGISTER OF DEEDS, NEW HANOVER
216 NORTH SECOND STREET
WILMINGTON, NC 28401
Filed For Registration: 10/18/2004 10:03:22 AM
Book: RE 4531 Page: 363-366
Document No.: 2004055363
DEED 4 PGS $20.00
EAL ESTATE EXCISE TAX: $1,050.00
Recorder: NANCY A SCOTT
of North Carolina, County of New Hanover
>regoing certificate of NANETTE F JONES Notary is certified to be correct. This 18TH of October 2004
A T. HRISTIAN , REGISTER OF DEEDS
ILe -I
ty/As.sis ant-Register seeds
*************************** *****************. ***..**.**.*****...*.........*..**.*.*..*......*.*.*.......**..
_OW PROBATE SHFFT IS A VITA1 PART C)P V ll IR PFC'fRfPn nnei tMGAIT

ATTr,,A,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Coastal Management
iael F. Easley, Governor Charles S. Jones, Director William G. Ross Jr., Secr
Notice of Intent to Suspend CAMA General Permit No. 43291-D
tified Mail—7005 0390 0001 3200 3027
urn Receipt Requested
January 9, 2006
Jeff Johnson
Johnson Marine Services
Turner Nursery Road.
nington, NC 28411
r Mr. Johnson:
This letter is in reference to CAMA General Permit No. 43291-D, issued to you on December 22, 2005, fo.
;truction of a private pier, platform, floating dock and boatlift, at your property, located at 317 Pages Creek Dr.
nington, New Hanover County.
Based upon information brought to the attention of the Division of Coastal Management by your adjacent ril
rerty owner, it appears that an adjacent riparian property owner notification was not properly submitted to the of
456 Dunbar Road (Lot#10 BR PH3) of Dunbar Landing Estates, adjacent to the property aforementioned.
Under these circumstances, the Division of Coastal Management is suspending CAMA General Permit No.
)1-D. The permit will remain suspended until the Division receives copies of the appropriate notification to the
►erty owner of 7456 Dunbar Road (Lot #10 BR PH3) of Dunbar Landing Estates. At that time, the Division will
uate the permit decision according to the newly supplied information.
I request that you contact Mr. Robb Mairs, Field Representative for the Division of Coastal Management in
nington Regional Office at [phone], indicating your intentions to comply with the request specified herei
:ly, you will need to schedule a pre-application meeting with the Local Field Representative prior to obtaining a
sed and/or new CAMA General Permit.
Sincerely,
Ji Gregson

RECEIVED
DCM WILMINGTON, NC
JAN 2 0 2006
JENNIFER L. UMBAUGH
Attorney At Law
Mailing Address:
7232 Wrightsville Avenue P.O.Box 1100
Wilmington,NC 28403 Wrightsville Beach,NC 28480
E-mail: Jumbaugh(a,bellsouth.net [phone](Tel)
[phone](Fax)
January 19, 2006
Mr. Robb Mair
Coastal Management
Field Representation Division
127 Cardinal Drive, Extension
Wilmington,N.C. 28405
Re:Pier Permit Application Submitted by Jeff Johnson,317 Pages Creek Drive,Wilmington
Dear Mr. Mair:
As you know,I am the owner of 7456 Dunbar Road,Wilmington,N.C.which is the property
located immediately to the west of Mr.Johnson's lot. I received on January 12,2006 a Waiver form
and a drawing indicating the structures which Mr. Johnson wishes to construct directly in front of
my property. This letter will confirm that for the reason previously stated I object to his current
proposal.
I met with Mr. Johnson on January 15, 2006 to discuss his proposal and to try to see if we
could revise his proposal in such a manner that my concerns could be addressed. It is my belief that
if he, you and I can could arrange to meet on the property perhaps we could come to an agreement
that would be satisfactory to all parties. I understand that Mr. Johnson will be contacting you to
discuss a possible meeting.
me
er . bxh
cc: Mr. Jeff Johnson do Johnson Marine
Mr Buck O'Shields

WESSELL & RANEY, L.L.P.
ATTORNEYS AT LAW
POST OFFICE Box 1049
WILMINGTON, NORTH CAROLINA 28402-1049
STREET ADDRESS:
JoHN C. WESSELL, III 107-B NORTH 2""STREET
[e-mail] WILMINGTON,NC 28401
WILLIAM A. RANEY, JR. TELEPHONE: [phone]:
WA RANEY@B ELLSOIJTI I.NET FACSIMILE: 910-762-755'
RECEIV
March 9, 2007 DCM WILMING1
Mr. Jim Gregson MAR 1 2 21
Mr. Robb Mairs
127 Cardinal Drive Ext .
Wilmington, NC 28405
Re: CAMA Permit Application
Jeff Johnson, 317 Pages Creek Drive
Dear Messrs . Gregson and Mairs:
I represent Jennifer Umbaugh in connection with a CAMA Genera
Permit Application submitted by Jeff Johnson to construct a pier on hi
property at 317 Pages Creek Drive, Wilmington, North Carolina. Ms
Umbaugh is the owner of the adjoining waterfront lot located at 745
Dunbar Road, Wilmington, North Carolina. The Johnson lot is accesse
through the North Hills Subdivision and the Umbaugh lot is in the Dunba
Landing Subdivision.
As you know, there is a significant history of applications an
permits related to the Dunbar Landing Subdivision and the Johnson to
(formerly Irving Hewlett lot) .
The current plan was sent to Ms . Umbaugh by certified mail wit
a DCM notification/waiver form. She received the notice on March 6, 2007
The documents sent with the notice form consists of a rather crude drawin
of a pier with dimensions and a copy of a general permit issued on 12-22
05 which was suspended on January 9, 2006 due to inadequate notice to th
adjacent owner.
Ms. Umbaugh continues to object to the proposed pier and dockin
structures for the following reasons :
_t

general permit where the riparian lines are located and how they ar
determined. The lines as shown on the unrecorded survey map prepared fo
Claud O'Shields and Irving Hewlett do not take into account any riparia
area applicable to the shorelines of the embayment that face southeas
(Dunbar Homeowners common area) and northwest (Nun lot) . The purporte
agreement seems to simply divide the bay into two parts, one for th
Johnson lot and one for the Umbaugh lot, and to disregard the rights t
the bay by the Nun property and the Dunbar Homeowners property.
2 . The proposed pier length of 150 feet from the edge of th
marsh appears to violate the one-quarter rule found in 15A NCA
7H. 1205 (n) . In order to achieve the purposes of the one-quarter rule t
leave a navigable area in the middle one-half of a water body, the one
quarter rule should logically be measured to the mouth of the embaymen
from the Johnson property so as to avoid having a pier from the Johnso
property obstruct a pier that might be built in a northwest direction froi
the northwest facing shoreline of the embayment_ The same would be :ru,
of a pier from the Umbaugh property obstructing any pier that might b,
built in a southeast direction from the southeast facing shoreline of th,
embayment. Even if the measurement is made to the marsh outside the ba'
mouth on the other side of the small natural channel, the distance is les,
than 600 ' and the one-quarter rule would limit pier length t,
significantly less than 150 ' from the edge of the marsh.
3 . Based on photographs provided to me, it appears that th
end of the proposed pier where dockage and boat operation is proposed i
in an area where the bottom is exposed at low tide. This area is unsuite,
for navigation by motor boats during almost all of the tidal cycle
Navigation in this area by motor boats will inevitably cause an excavatio:
of the bottom. The area is an active and productive area for oyste.
growth. According to an earlier field report regarding this area, it i
within a primary nursery area. (I have been unable to confirm this) . Thy
applicant has made statements that water depth will not be a problei
because the area can be deepened through excavation by boat propeller
showing the certainty that excavation will occur.
Based on the foregoing, the application should be denied. I:
the alternative, the applicant should be required to proceed only throng.
an application for a major development permit in accordance with th
discretion provided to DCM staff in 15A NCAC 7H. 1202 (b) (2) . I will bi
happy to discuss any of these comments in more detail if you wish. R EC EI
Sincerely, DCM WILMIN(
MAR 1 2
wpggFT.T. f. PAMPV T, T, p

DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM
Name of Individual Applying For Permit: ��fe) ,° S
Address of Property: 1 Payer l r`c2k Yr
(Lot or Street#, Street or Road)
(AI; l� ,>� � � / hay
(City and County)
I hereby certify that I own property adjacent to the above-referenced property. The indivic
applying for this permit has described to me as shown on the attached drawing the development I
are proposing. A description or drawing, with dimensions, should be provided with this letter
I have no objections to this proposal.
If you have objections to what is being proposed, please write the Division of Coa.
Management, 127 Cardinal Drive Extension, Wilmington, NC 28405 or call 910-796-7
within 10 days of receipt of this notice. No response is considered the same as no objectio
you have been notified by Certified Mail.
WAIVER SECTION
I understand that a pier, dock, mooring pilings, breakwater, boat house or boat lift must be
bck a minimum distance of 15' from my area of riparian access - unless waived by me. (If;
wish to waive the setback, you must initial the appropriate blank below.)
I do wish to waive the 15' setback requirement.
I do not wish to waive the 15' setback requirement.
RECEIVE:
MAR 1 4 1007
BY•
S'` Name ate _=
-/\". 4/,.i/A/
Print Name �4 •a

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rit,__L
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o te -.y1 h1
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cal —4 --io r01/,...,v, ,, d ',7J 30 CIA!ni_,�Q p i-ofi.r4 oo e - /0 - Lo

r irr--- ,1
-CAMA`/ E DREDGE & FILL -
iE-NIERAL PERMIT Previous permit#
New ❑Modification Complete Reissue Partial Reissue Date previous permit issued
imed by the State of North Carolina,Department of Environment and Natural Resources ',z000as i Resources Commission in an area of environmental concern pursuant to I 5A NCAC
rr�/- Rules attached.
:Name left Project Location: County N e- - / ' '
317 PG s (vtC 4 ,d/', Street Address/State Road/Lot#(s)
0I/T/iy*' State /p' ZIP .'tSI' / 1/ f plr l/'e A /2 ,
(9 v) �0$, 033 Fax#( ) ) Subdivision A r�r H.N.
.d Agent ,&Yil/ JD4�,7 (Ii16/1 f' City h1/�M1/y�h ZIP Veil'/,
LT.CW SEW / PTA `ES _PTS Phone# ( ) 21 River Basin el!p/
C OEA -I HHF ❑IH ^UBA -N/A e' `�
Adj.Wtr. Body /`6ils�S �/'r�'� (nat rr
PWS: O FC: ✓✓ ,
yes / PNA yes / no Crit.Hab. yes / no Closest Maj.Wtr. Body / 4"i' �-"�
Project/Activity rev,.S J /teetiOh /7 Oi/'I/4 7:, �pie/' . /—l„--,ad p h 74 r""fr
(Scale: / /
.6 .
er(s) I
I --
igth i 1 . I,D flee pie
I.
nber I 1P
I/Riprap length r • IW-----Iv--VT-_' �G4 /�+" —..
;distance offshore r l I , `
`F�j
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cannel j .
' 158 (
i
)ic yards t I _
ma ") ' Imo' y . �.-_ __ - _ - _ ' '� Dis144,Cl.'.•
se/ oatlift K — ytjf1T.i i
alidozing I
{� ! j ---- I 1 - -- 1 -- ---
f/vet",^
e',.'xI '
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1 1
e Length . • - , 1 I I not sure yes 1 'L __--
s: not sure yes 1v_- .., '� 1 to .
cum: n/a. yes __r___—
Yes�y( �Old --- l
kttached: ;list g Ind — — p —>> `�I ` �_.:__
ng permit may be required by: Al 117 a, /�/,J/ /
T/f /
n See note on back regarding River Basin rt
Special Conditions Rid(!5 q i ia©o ,i rid 77' ,o,- e" , O/W i 44iif1refrry,4 /l iJ�

Cc'f 'c
eive
STATE OF NORTH CAROLINA
Department of Environmental and Natural Resources
127 Cardinal Drive Extension
Wilmington,North Carolina 28405
[phone]
FILE ACCESS RECORD
SECTION C"1
TIME/DATE '9; 5
NAME cre.4. 5,4,7
REPRESENTING Se/'
Guidelines for Access: The staff of Wilmington Regional Office is dedicated to making public records in
our custody readily available to the public for review and copying. We also have the responsibility to the
public to safeguard these records and to carry out our day-to-day program obligations. Please read
carefully the following guidelines signing the form:
1. Please call at least a day in advance to schedule an appointment to review the files.
Appointments will be scheduled between 9:00am and 3:00pm. Viewing time ends at
5:00pm. Anyone arriving without an appointment may view the files to the extent that
time and staff supervision is available.
2. You must specify files you want to review by facility name. The number of files that you
may review at one time will be limited to five.
3. You may make copies of a file when the copier is not in use by the staff and if time permits.
Copies of 25 or less are free,26 or more require payment in full for all copies made at 10
cents a copy; payment may be made by check,money order,or cash at the reception
desk. Copies can also be invoiced for your convenience.
4. FILES MUST BE KEPT IN ORDER YOU FOUND THEM. Files may not be taken from
the office. To remove, alter,deface,mutilate,or destroy material in one of these files is a
misdemeanor for which you can be fined up to$500.00.
5. In accordance with General Statue 25-3-512,a$25.00 processing fee will be charged and
collected for checks on which payment has been refused.
FACILITY NAME COUNTY
1. re Pig ,7;)4hsi,4-7 611 4J C&
2.
3.
4.
5.

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. $ignatu
item 4 if Restricted Delivery is desired. ( 0 Agent
'�`r
• Print your name and address on the reverse ��ty\}"i)(i a , "k C3Addressee
so that we can return the card to you. B. F ceived by(Printed ame) C. Date of Delivery
• Attach this card to the back of the mailpiece, . . ---)
or on the front if space permits. i .
D. Is delivery address different from item 1? 0 Yes
1. Article Addressed to: If YES,enter delivery address below: `QJIo
JewJ1 A/1 0
�Joh✓7s0/1 1-/Or7 `` Svcs .
i"
C- a- ' / 3. Sery,0 Type
�,t i f ry,•i Certified Mail 0 Express Mail
v ❑ Registered 0 Return Receipt for Merchandise
❑ Insured Mail 0 C.O.D.
4. Restricted Delivery'?(Extra Fee) 0 Yes
2. Article Number 7005 0390 0001 3200 3027
(Transfer from service label)
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
U.S. Postal Servicerrr
N ' CERTIFIED MAIL, , RECEIPT
p (Domestic Mail Only;No Insurance Coverage Provided)
rn
For delivery information visit our website at www.usps.com:
FFICI
❑ aQ' ,.
m Postage $ L US
ru
. 3/
1-9 Certified Fee („ 0
Return Receipt Fee -c�` Qr
(Endorsement Required) I-Fs r• g O
O Restricted Delivery Fee 0O
a^ (Endorsement Required) O 0
1 r -
m 30 �N
O Total Postage&Fees
Sent To DO _AC'
En .Jel, cJ Ahsc11 - USPS
r` Street,Apt.No.;or PO Box No. Gt-Al/001. l/.Sn1�A fC p
•
City,State,ZIP+4 )/ t).•- (7//
r'S Form 3800,June 2002 See Reverse for Instructions
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3.Also complete A. ture
item 4 if Restricted Delivery is desired. 0 Agent
II Print your name and address on the reverse X�• I Add(- e
so that we can return the card to you. B. R- eived b1(Printed Name) �jji- erY
• Attach this card to the back of the mailpiece, �f
or on the front if space permits. /'' A uv7
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: if vic .tar rior„on,arlri.ace hpinur D No