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" `1o.., 19(CAMA REDGE & FILL NO. 85503 A B C GENE L PERMIT D revioupers mipermitt issued New ['Modification ❑Complete Reissue 0 Partial Reissue PDatereviopus As authorize by the State of North Carolina,Department of Environmental Quality environmental the Coastal Resources Commission in an area of erronmental concern pursuant to: I SA NCAC `\ , ,\O 's c1 \. X.I oO ❑Rules attached. [General Permit Rules available at the following link:www cion ncmViCAMArules Applicant Name Tkr...- sJ 41C.,ve e...s ii Z ..j j s i Try t Authorized Agent �c.'� � V r s uz ' C (/C?\ w`sck �h!'r vC.Address , V ,�n�S e✓ C.r�� Project Location(County): ` ✓ �.1�-%t- City D-fn 1 C, \7t kState ,f.,___.__zip_V I Li le±'— Street Address/5tate Road/Lot#(s) 1414{ 61 Phone#( LO) J Q CI 570Le Email st,Apc.� ' sI / tuy c,C41^^ Subdivision City c+n uA'�Z.ec.J.-‘ ZIP 2 gy(.Sl Affected CW EW PTA ES ❑PTS Adj.Wtr.Body 1,(fir`-- Ct a-- an/unk) AEC(s): OEA n IHA UW SPIMA PWS Closest MaI.Wtr.Body___j1,1cr. - Cn.tt.---- ORW:yes/.sue_ PNAG/no Type of Project/Activity (�',,(4.c.4- t _a \� eti.t\"� t�.I f/•.& t' U(2••A r-�� J+t----) (\ut\i r tz<<<\. (Scale4-)7l ) . Shoreline length 5-0 Access Length LI g 'a 4/ v ` \�^` r f��`� ��..�� Pier(dock)length ti Y v`t N� l.• Fixed Platform(s) /D st It nee, r a vt, %vp A.,...s r 11' F•Ocd Floating Platform(s) I y 5' \`\\ 6• •,v�� dv�� Finger pier(s) W Total Platform area / /G.4 4. f1 i sZ Groin length/R i lAu\,.a t. CNQ r •1 Bulkhead/Riprap lengths 0 / i J, l ACAS h ( (J ` Avg distance offshore `� S L. ‘‘. Breakwater/Sill .. ,.. Max distance/length `' ' L. .. Basin,channel ,. t. ~ A. Cubic yards y rJ}\• G Boat ramp Boathouse/Boatlift f I C Lc} (..-.15 v i J L. Beach Bulldozing ti'i iMPic.c.- Other 51 Ze�� Hr0e��V. — vet' { SAV observed: yes ) ‘ 51, J ` `�� k)t... S , Moratorium: n/a yes I J Site Photos: � Riparian Waiver Attached: /vesli.,Lno A building permit/zoning permitleit may be required by: Su A St'k" (l •f k e( - �\1 +2 b AV' J t." v C. ElTARJPAM/IVEUSE/BUFFER(circle one) 4. Permit Condition 7cc I � 6 a5p Aru p 1 G ,M ,�,;• \ h.t 4 ddL�1..�.,i... 0 2' 0.100,)v 0 See note on back regarding River Basin rules S`�� S r .,`lL D See additional notes/conditions on back •r• et 1 4 ••� \ / ` I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPUANCE STATEM (Please Initial) INcr- a 1r.G_ct CT_;_ . +Ur �." l -mac ,ent or Applica t PRIName Perm er s 1 ED Nagap----"? s....._... 5-la-2072 SignatyrJ'"Please read compliance statement on back of permit n _ Signature I _ r/ / 4° '"° � .'r'CAMA I• I DREDGE & FILL No 85503 A B (Er:,c .GENERAL PERMIT ,4 Previous permit Date previous permit issued New n Modification Complete Reissue ill Partial Reissue As authorized by the State of North Carolina,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to: I 5A NCAC (\ A'\ -\ \`LA.) 1 01\\ O Z oU ❑Rules attached. L.-':.. General Permit Rules available at the following link:www.deq.nc.gov/CAMArules // n 7 \ Applicant Name 'T(\.c C1 t._(D 7 , '.1+ e e``',1, t�,.. 1- -t. c/- Authorized Agent : .) •' c__ G, , Address Xc Uk^.Z`' (• J W C/O G-^%(‘ ',AN( r,, J ((�� � < Project Location(County): \ ^},-- ‘c <•- City' `'1 v- U[kState P (. ZIP 1 �1 ' ) Street Address/State Road/Lot#(s) !li1 LI 66, s-T' Phone#("\(0) )(.60 7 70LP J Email 6cav'<. -p 'Iit (9 ,„tk- - k_, (u,-,- Subdivision 1/ City • ,.a \J t A ZIP 1 �'i 1(..Z Affected I,••'''1 CW n EW PTA ES ❑PTS Adj.Wtr.Body (C.' --• - �,(aa an/unk) AEC(s): r OEA IHA UW SPIMA ❑PWS Closest Maj.Wtr.Body ,i; ,-t¢t•��.-- ORW:yes/no PN ye no 'ype of Project/Activity (2-e el,Le__ �kot..c., a ,.., , ,<,k,.. (Z�tP✓•�� cv A. (c,�sk<,�L%t- v'4- ---) �� c_) t (Scale:J�7 I ) Shoreline Length 0 -3 ", ' 1 i Access Length g ' 4 , �. ^-L e - ,�� Pier(dock)length y Y Y 1 ..._. !�_, ............,,� .-" '-✓ Fixed Platform(s) lO Y I?_ e n ,nee j — 1--1 1 'NI ils Floating Platform(s) I � a Finger pier(s) i W' ^s j I l Via' ,___ Total Platform area !-12' F� ] i 17.• 'N1 Sroin length/# 1 c4JfJ �N Bulkhead/Riprap length- ')�� i'I - L • (` `� — �__ , _ ( _ _ 4vg distance offshore 0 -...._ ___ ...... } - _ _ __ -. ...._... ..- �............ _ f- . �t c�..�_� Breakwater/Sill ' y I ,.. Max distance/length l w 3asin,channel l - 1 ' U ,.' ` 2ubic yards 1 py i Boat ramp a 3oathouse/Boatlift �' GV t� �.�S C� 3each Bulldozing f .. �_ Q �rf4 Dther ` i j . ;AV observed: yes ti� , I. T 'T' _Po Oa� r ' 'f V Moratorium: n/a yes E fit` - I • l �� 11� �6'� Ci i iite Photos: I tiparian Waiver Attached: ye no i I i ,... .'IL 1 W \building permit/zoning permit may be required by: Su-'at 1 &.C'(Y\ t� i �, b 1,...3 i,� D ❑TAR/PAM/NEUSE/BUFFER(circle one) ermit Condition p 7- (�, r 4,-- L .,, c)s< / c_)l <-- w _ ) ,,°e c�r v-�e 1"��'��' --5i-- \--•\\ o1 `-- °"�^,^ ^ °/ '2 ' ect�r)4 (.; ❑ See note on back regarding River Basin rules S.)bSk- :,' _., C.)11._�.�; A.a.L ,. .A\ i' �,L,, 1, Q (, ^ r [i'), S 4 G�,' d` \\ (�A f,Lc ❑ See additional notes/conditions on back AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED.. OMPLIANCE STATEMENT. (Please Initial) gent or Applicant PRINTED Name Permit Officer sPRINTED Name Statement of Compliance and Consistency This permit is subject to compliance with this application and permit 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 from the adjacent riparian property owner(s) has been obtained, or proof of delivery of certified mail notification of the adjacent riparian property owner(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 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 Resources. If you have any questions, please contact the Division of Water Resources at the Washington Regional Office (252-946-6481) or the Wilmington Regional Office (910-796-7215). Notes/Additional Permit Conditions: Please ensure all debris associated with the removal or construction of the permitted development is contained within the authorized project area and disposed of in an appropriate upland location. Division of Coastal Management Offices Morehead City Headquarters Washington District 400 Commerce Ave Morehead City, NC 28557 943 Washington Square Mall Washington, NC 27889 252-808-2808/1-888-4RCOAST Fax: 252-247-3330 252-946-6481 (Serves: Carteret, Craven—south of the Neuse River,Onslow Fax: 252-948-0478 Counties) (Serves: Beaufort,Craven—north of the Neuse River, Hyde, Pamlico, Tyrrell and Washington Counties) Elizabeth City District Wilmington District 401 S. Griffin St.Ste. 300 127 Cardinal Drive Ext.Wilmington, NC 28405-3845 Elizabeth City, NC 27909 910-796-7215 252-264-3901 Fax:910-395-3964 (Serves: Bertie,Camden, Chowan,Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties) • • ,.•,::,:.. . ... : • ••.. . .• ..•• •• • . : :: . . .. . . .. ...: ..... . .. . . • ... ..: . . • . •. 1::. ... • • .:.:. . ...: :. . . : . .. . ./.. .• . : : :. , , . : :. :••:•:•.„,...:,,,oph6riiiitinbiii.:.: :. z...-". . • -• • • • • .:•••••• •••••••••1:::::::-.;•;:..!..:..:::::::..ernali.......,., ,.,Adcliiiisi..,.. ....,,, :•:', ; ;;;::::. :. :::: ..,:.::::•••'.• •• "- •• -.i-...; -.3.• .; .....";.::0,..,.... it:. ./•vt.,A4. •,'.ieflify•t• •': : • : ;• ;.•.;•... .••.r. .:..: :: .:• : .:: ...;: : .. •.' .:...:• • • .: • ; : ::::. ;.;::.......:ForYthiOiliha—ve atiiiito.ii. . .flici:..:.. _-f‘-%-r-Aci - : te6b-i<5....4K4'.. ciA.A. -... ' • ' ' ' .:. . : ' . ..... • • : .: .. : : :.:..:.. :.. ' . .••. ::.': :. . 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DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL • RETURN_RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) 44 Name of Property Owner: �. - r C4'4' L�.Y • L-4 i. (r it Address of Property: 1 H s S-trEe-t, .S s.t.4- M ach Mailing Address of Owner: 149 UJ' t dS or Cr, 5.1h-) Oc.eav• I It ti.4c,k 6 C Z-fi40 Owner's email: Owner's Phone#: 9jU''"'6 -57O:a (,, Agent's Name: v[ f C fCOkirtld(0/1 Agent Phone#: qtd 5—let i 615 Agent's Email: W Rix Rixria fi a Q -t ( 1 ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adlacent Property Owner) I hereby certify that I own property adjacent to the above referenced property.The individual applying for this permit has described to me, as shown on the attached drawing, the development they are proposing. A description or drawing, with dimensions, must be provided with this letter. I DO NOT have objections to this proposal. I DO have objections to this proposal. If you have objections to what Is being proposed, you must notify the N.C. Division of Coastal Management (DCM) In writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive EXT, Wilmington,NC 28405.DCM representatives can also be contacted at (910) 796-7215. No response is considered the same as no objection If you have been notified by Certified Mall. WAIVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15'from my area of riparian access unless waived by me (this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign the appropriate blank below.) I DO wish to waive some/all of the 15' setback --77f Signature of AdJ nt Riparian Property Owner(ARPO) 0\^ \& OR .f 5\,\s • I do not wish to waive the 15' setback requirement(initial the blank) ' <---0"`�� �c�•‘ � c „ Signature of Adjacent Riparian Property Owner: ` Typed/Printed name of ARPO: 4;, Z Mailing Address of ARPO: 19 I (.4" CA.•--t a- S'��^-C-c-'k 0 r� ARPO's email: r Zr--°'f LL�c c Y ARPO's Phone#: Ltek � 53 -z-f(r'7 Date: 1 1 17 12 \ "waiver Is valid for up to one year from ARPO's Signature* Revised May 2021 U.S. Postal ServiceTM CERTIFIED MAIL® RECEIPT - Domestic Mail Only For delivery information,visit our website at www.usps.com''. a u fFIC A I... USE 3 Certified Mail Fee $3,75 047(1 $ I- ric. 11 Extra Services&Fees(check box,add fee n (1,15nrilite) 3 El Return Receipt(hardcopy) $ 3 El Return Receipt(electronic) $ SO_UO Postmark 3 El Certified Mail Restricted Delivery $ Si 00 Here 3 El Adult Signature Requited $ 00 El Adult Signature Restricted Delivery$ 3 Postage $0.58 a $3 Total Postage and Fees S 11/12/2021 _ $ Senojcief.i.-- /4114 3 , trrol5t. q or P0‘15 XtrLtJrsin, citsLY Ad tate,ZIP4-4 - vi44,4 .ieruTlea Mall service proviaes me Toilowing Denents: A receipt(this portion of the Certified Mail labeh. for an electronic return receipt,see a retail A unique identifier for your mailpiece. . associate for assistance.To receive a duplicate Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the A record of delivery(Including the recipient's retail associate. signature)that is retained by the Postal Service— -Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent vportant Reminders: -Adult signature service,which requires the You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Service®, available at retail). or Priority Mail®service. -Adult signature restricted delivery service,which Certified Mail service is not available for requires the signee to be at least 21 years of ago international mail. and provides delivery to the addressee specified Insurance coverage Is notavallable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark.If you would like a postmark on For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail Item at a Post Office-for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt'attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. ENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY t • Complete items 1,2,and 3. A. Signature • Print your name and address on the reverse X / I [d�Agent so that we can return the card to you. if... bb Addressee • Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date off-Delivery or on the front if space permits. C b I �'1/S 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑No 5575 St Pd Puny N c , ,33(-( 11111 III II I II I I I I I I IIII IIIII 3. Service Type❑Adult Signature ❑Priority Mail Express® 0 Registered MaiITM ❑Adult Signature Restricted Delivery 0 Registered Mail Restricts lerCertified Mail® Delivery 9590 9402 5492 9249 3653 76 ❑Certified Mail Restricted Delivery rIfDReturn Receipt for ❑Collacr^^Delivery Merchandise 2. Article Numhpr rrranefc.s...—.-- • • • )elivery Restricted Delivery 0 Signature Confirmation° 7017 0660 0 0 ?4 86 9 4 7 8 I 0 Signature Confirmation redlGfalI Restricted Delivery Restricted Delivery — — (over$500) PR Pr rm 3R11 .Inly 9015 PRN 75 tn-n9-nM-g05a Domestic Return Receipt USPS TRACKING# First-Class Mail I r I I 11 .0 I .II I,I I I I 81- Postage&Feet Paid it I 5 USPS Permit No.G-10 9590 9402 5492 9249 3653 76 United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service GRICE CONSTRUCTION 6618 BEACH DR. , SW OCEAN ISLE BEACH, NC 28469 a►5°'y G cO c i OOO r • `• 6• ce 4r � d, pp ' yd Li) , ', .o�Q 0,.. ` kg.� ',� o03cm�c��° ',YP `. rye• ® . . 8- ;:1. o s ‘A -oCl o. <. M S A o .. ba C' i; °° d+' ✓ o V,. �$ d•, 1' o d� V• w, i. ION ON DELIVERY ' COMPLETE sP v j 1 SENUE.1: P cr 9P ❑Agent ■ Crint yo a item' 1,2, = P ,j m -Mt Cyr 1 c/ ❑Addressee ■ Print your name and add . • t'� a C. Date of dress so that we can return the c•� c3. Received by(Printed 1 Delivery • Attach this card to the back 1-S \ s g v i ( I�' I or on the front if space permit °,o' D. Is delivery addres i rent from item 1? 0 Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No 1'-l\t a 5-t `'-°`-k-- 1 kCkoc\I\_ N1c 2sg66 504 3. Service Type 00 Adult Signature Priority Mail Express® O Registered Mail III'III�I I'II I'I I IIII II'II'II III 111111111 1111 ❑Adult Signature Restricted Delivery ❑Delivery Mail Restricted ?Certified Mail® �❑o+.,.^Receipt or n ro.��s�o.a n��;i o�..c,..<.+nel;„e„, ndise 9590 9402 5492 9249 3651 23 re ConfirmationTM re Confirmation ed Delivery 2. A rt'v v�,,,C,,,�Return Receipt S Form VV 1 I,Vuly LV IJ rJ1Y IJJV-VL-UVV-ouoo -p C '•x OO %,., O C1 iEt O. -13 o �� Z sr)CD illENIMINI Fi'f,, o c .Len,. ini cn •q'',e, -,ea,M r •Fr,ae/e%a/�tsAp a// � aeh�e°Ojc�,engg �Oa `S@ ru re0/04 e�/,pder:1 fthe�IQ • n d of ° 4- ,t. fl I s� �aes`e�/p ofa°/ie p/o e t Apo m + 8 ,,, eaue-0447 a aug °�daeui• �//.•es tb! 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W M n _ `; �alsuo��p�b°/Au�p ga�air4eetp turoseeesa ees°pKhich °ced�rtb le R I V(M1' 7i � caiy:.aGgeyo0„%fie an,,„ip„#8tgna,e4�as,e,whn,°0t_eabyu`aes °fie z..:.:: \ 1 x co, 9) .....: yopt, aeaht, . /nay e„,/ke,esgoe Oki yoa4'f4%, d�P or _ M Q uuiay�e a 0,,,,, 47/ab/4 tke��aae4Lp ge/nothe M N 90 e e e e !p / �y __ z /�+ Ci En `;i,. rsaesa °et 4SS°S,00A,p,—cZs�atyppat�etdv eS e7,70. jy6, 0, n • y Q' e etptao'O �er�Ygearbaiy�9ftu�`bfBO sae+h nee peco ag'e ...'�:: c ' tug -:: Co H a ,ytr r„,, ofte alaa�a/4.6,rey,.400 0/, tee, r°ate, 6) SN Z13 p�e p; dAp�p�ryaabp�a��ppt �t� hype't s G�°be '..: `"` ® 7..c 0 7! 72 /Tjpn_ ppstvgttp6'eegch an.cpop3Z�)pregtyOdrkpnara g m a N epa> '�4y� a9aa�aiptebarcOtiar� Z(n Sa°"lhts e°°sh' �anp°a40 is �' N 2 po� try o p4 ! C i o 1) CD N ��yOpi O N.— '4,:v no U Q. N.C. DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATION/WAIVER FORM CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY (Top portion to be completed by owner or their agent) Name of Property Owner: r cqN., tcA i4ky , L-i\i, Tr f Address of Property: 111 tH WA Sl r -fi S4hci.ttie 4j Mailing Address of Owner: 1 i 1 �,Jtr dS Wr C►f, S U Dcpa�-15-4 ga,4c,1ti 6 C Zfi90 Owner's email: Owner's Phone#: el j U" no -57044 Agent's Name: Ur(C f C }r tict(b/1 Agent Phone#: IV O 5741 R 6 -5 Agent's Email: W grtlG c (r_t a R`-►i'tc, (LtA-- ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION (Bottom portion to be completed by the Adjacent Property Owner) I hereby certify that I own property adjacent to the above referenced property. The individual applying for this permit has described to me, as shown on the attached drawing, the development they are proposing. A description or drawing, with dimensions, must be provided with this letter. I DO NOT have objections to this proposal. I DO have objections to this proposal. If you have objections to what is being proposed, you must notify the N.C. Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Correspondence should be mailed to 127 Cardinal Drive EXT, Wilmington,NC 28405.DCM representatives can also be contacted at (910) 796-7215. No response is considered the same as no objection If you have been notified by Certified Mail. WAIVER SECTION I understand that any proposed pier, dock, mooring pilings, boat ramp, breakwater, boathouse, lift, or groin must be set back a minimum distance of 15' from my area of riparian access unless waived by me (this does not apply to bulkheads or riprap revetments). (If you wish to waive the setback, you must sign the appropriate blank below.) /J I DO wish to waive some/all of the 15' setback / „�' Signature of Adjacent Riparian Property Owner(ARPO) -OR- I do not wish to waive the 15' setback requirement(initial the blank) Signature of Adjacent Riparian Property O ner: MD-yv,)Z------ IN•Typed/Printed name of ARPO: "�`\ �_e N� _Mailing Address of ARPO: �� 3- C 1/4 c,uze* � � 7�SZ1 a ARPO's email: ( v`:2 -'�(F \ 'ARPO's Phone#: 1 D 010 1 Date: \ \\7_z �\ *waiver is valid for up to one year from ARPO's Signature* Revised May 2021 I. . 'os a ervice ., CERTIFIED MAIL® RECEIPT a Domestic Mail Only I- ^ For delivery information,visit our website at www.usps.com''. c h ftct "c;,,t2jA :fri=71 3 Certified Mail Fee 047 i:t$ "2'..-115 1 I Extra Services&Fees(check box,add fee ef frprilate) 3 1:3 Return Receipt(hardcopy) $ -- 3 El Return Receipt(electronic) $ $11. UI Postmark 3E Certified Mall Restricted Delivery $ 00 Here 3 0 Adult Signature Required $ SO Adult Signature Restricted Delivery$ a Postage 58 3 $ 11/12/2021 3 Total Postage and Fe*s _ $ Sentedetinv,t St3p6c13t.toriZDzNotzs4 t c 6 :eranea man service proviaes me rouowing oenenis: A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail A unique identifier for your mailpiece. associate for assistance.To redeive a duplicate Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to tfie A record of delivery(Including the recipient's retail associate. signature)that is retained by the Postal Service'" -Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent. nportant Reminders: -Mutt signature service,which requires the You may purchase Certified Mall service with signee to be at least 21 years of age(not First-Class Mail°,First-Class Package Service°, available at retail). or Priority Mail°service. -Adult signature restricted delivery service,whict Certified Mail service is not available for requires the signee to be at least 21 years of ag international mail. and provides delivery to the addressee specified Insurance coverage Is not available for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the •To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear certain Priority Mail items. USPS postmark.If you would like a postmark on For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office"for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. M ENDER: COMPLETE THIS SECTION COS IPLETE THIS SECTION ON DELIVERY • Complete items 1,2,and 3. A. Sr • Print your name and address on the reverse X ❑Agent so that we can return the card to you. ❑AddresseE • Attach this card to the back of the mailpiece, B. celved by(Printe ame) C. Date of Deliver) or on the front if space permits. C'N\1 1\(_.- DI&)e- 1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes l �, If YES,enter delivery address below: El No ariu CA 46 5Lt3 � ColaCZ-J NOVc22t'2i -._ ,. e. rt4 tt` l,(C Z S2'71) Q614, emu(?el‘... III II I II I I I I I I III I I I i l l 3. Service S i Type ❑Priority Mail Express© ❑Adultgnature ❑Registered MaiITM ❑Adult Signature Restricted Delivery ❑Registered Mail Restrict( 9590 9402 5492 9249 3653 69 (1pCertified Mall® Delivery 7Certified Mail Restricted Delivery lfg Return Receipt for o Collect on Delivery Merchandise ❑Collect on Delivery Restricted Delivery Signature Confirmation'',2. • ,,...-nhar(Transfer from service label) ❑Signature Confirmation 7 7 0 Insured Mail 0 6 6� Q Q Q 0 7486 9485 n(^cured Mail Restricted Delivery Restricted Delivery PS Form 3811.July 2015 PSN 7530-02 Domestic Return Receipt USPS 1RACIW G# First-Cla::s Mail I I Postage&Fees Paid ifir USPS !I1111 i Permit No.G-10 9590 9402 5492 9249 3653 69 United States •Sender:Please print your name,address,and ZIP+4®in this box Postal Service GRICE CONSTRUCTION 6618 BEACH DR. , SW OCEAN ISLE BEACH, NC 28469 i)i'i��'til1i►,l3i!'i�1��iI'`I'i{{'{'itl�II'tllfil�„I'1iii's�iJii I\ `ro ' Ti) _) -c I1- l i- Zk t-K061Q 4 [4G 111 ,ic,k SAS SA r— A �a r-A sc1,01 1Vt c Z 1331 I r ' 6-f a - - v2 a 4 , f / I //flack 1,1,4 l Kka.cl -Fe ipir Sir eel- arft: ;,, `T-PA-64- - tti35 Cr-cick lc( 51,,rF Slt!bseA- 13,4C14 14( 4 iet r C -5GJ Ovw gt Ill G CQ,cA...Tab ac-ccLA P Cheek Dab Rom/von Dote DepoolNd Check From(Nemo) Nan»of Permit Holder Vendor Check number amount MNtMm brh:omm.nts Receipt or Refund/Realloo Column., Cakmn2 Columns Column/ CokmnW Column. 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