85136B - Pamlico County

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id"D"`'r ALMA ❑ DREDGE & FILL NUJ 85136 A C D
i a t`'I NERAL PERMIT pPrevious permit 73 VI73 -�
New Modificationy27 //9
('_ ❑ ❑Complete Reissue []Partial Reissue
As authanzedb-7 State of North Catches,Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to.
I SA NCAC I/ /ofµCD ElRules attached. General Permit Rules ava/able at the following link www.deo nc gov/ tArvles.
Applicant Name_ �M�f co Co . Authorized Agent " -----
Address_?c) 3a yC 77 C, Protect Location(Counry). P �-�— —
City Sae NC ZIP '2an IS Street Addre�s*s/Srate Road/Lot#1si r!i23( a en
Phone#4 47/ rj f 9c eJ` 2ur _-_— --..
Email Subdivision
City /c. / p� _.--ZIP 20'57 —_.
Affected ❑CW EW al PTA ❑ES OPTS Mt Wre Body /t/(.e.. F+—lv,/^---- _�'*•�y an/unk)
AEC(si: """�i°EA Li' 7uw 0SPIMA 0PWS Closest Mat.Wrr.Body �4-sca.0 v� .
ORW:yes! PNA:le/)
Type of Project/Activity /�,�r,h 2?p S �� �i+ /i j G 'K Z r
(2_)5?si Yi.t��'r�S lO_//Z0' � / {Srale:A/TS )
Shoreline Length i 2 So
Access Length �v ., tg
Pier(dock)length ( g / , Rr✓�
Fixed Platform(s) 5.7C AG 51&' 1� f s'
Ebeling Platform(s) -
Fingerpier(s) - e.�/A
Total Platform area 1�0 1.1 Pr-�`�!
Groin length/4 7 �//7/S4 fie
Bulkhead/Riprap length
Avg distance offshore I I
Breakwater/Sill
Man distance/length
Basin.channel
Cubic yards
Boat ramp
Boathouse/Boatlifi
Beach Bulldozing
Other /
SAV observed. yes _� Q, �a� •
Moratorium. n/a yes G / _• &kyr i'� 1 -17, '�'_
Site Photos: yes o �j dta, 1�1 i Cb Cs- �.
Riparian Waiver Attached: yes �"•'�z Pe op i�'"y'
A building permit/zoning permit may be required by ijF+I•,,c, LQ cRTAR,'PA EUSEi UPPER(urc!e one)
Permit Conditions
EidSee note on back regarding River Basin rules
❑See additional notes(condihons on back
I AMAnAH E OF STATUTES,CRC RULES AND CONDMONS THAT APPLY TO THIS PROJECT AND REv1E O COMPUANC TATE _ (Please Initial) _
t o ern C. 17" +s -r1
Agent or pplicant Ponta . Name Prffnit Olhce ED ai
Signal 'Pleeaase re A compliance statement on back of permit'•• Signatur '
Application Fee s) Check 4/Money Order Issuing Date r pitatton Date

sokCO"'ulet,v..X1CAMA I I DREDGE & FILL No. 85136 A C D
Previous permit 7 3 V
7
( G E N E RAL PERMIT Date previous permit issued
n New I I Modification I]complete Reissue ElPartial Reissue 2/2-7 / /9
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 SA NCAC 7H /2 a ❑ Rules attached. X General Permit Rules available at the following link:www.deq.nc.gov/CAMAruleq
Applicant Namef (,d / P:o1 /r Authorized Agent ��
Address ?O /l� C�a)4 7 7 Project Location(County): GO( ^/, /_,,
City 2't. �u State NC- ZIP 2Z75 /S Street Address/State Road/Lot#(s) (0g � y/I� C/h
Phone# et7/ 57 98 L3&c-02 ,2i,
Email Subdivision rr
City �/7G:AraL, ZIP Z41"5-7/
Affected CW )4 EW PTA n ES n PTS Adj.Wtr.Body �[I�SC- F ')/4 ' Fran/unk)
AEC(s): OEA uI IHA UW n SPIMA n PWS Closest Maj.Wtr.Body w £ ,61.4.�----
ORW:yes PNA:ye
S C /
Type of Project/Activity 2p/ / � t z t Z/ is' X za
19
2)S n/4 IA ' /O� Zo' �i—
/ ((Scale:OM )
Shoreline Length ✓ 2-SO I
Access Length / `MIN
`I
Pier(dock)length IV
Fixed Platform(s) sX./� ;.s,2/4.� NV, fr/e-'1'
Zo,
Floating Platform(s)
Finger pier(s) L
Total Platform area �(I 0I'l l— /P1'c�e'�-O
Groin length/# s/ 7 "Mw> 3
Bulkhead/Riprap length
Avg distance offshore 1 I
Breakwater/Sill
Max distance/length
Basin,channel
Cubic yards
Boat ramp
Boathouse/Boatlift
Beach Bulldozing _ --
Other
SAV observed: yes C n J /V LA/L
•
Moratorium: n/a yes •G /0 /r3� TZ, 1
ite Photos: yes �ioj s rr4ri 1 rNh(f tA Cry Riparian Waiver Attached: yes /l op Pe
A building permit/zoning permit may be required by: (A f
Permit Conditions / cSt
TAR/PA EUSE/ UFFER(circle one)
-V See note on back regarding River Basin rules
nSee additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIE D COMPLIANC TATE ET. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer' ED a
Signat a**Pleeaasse re d compliance statement on back of permit** Signatur
Z--- _2/„2 3 d 3 Af•e✓f 28/ Za Z Z-- Z:5" 2 ZZ�
Application Fee s) Check#/Money Order Issuing Date piration Date

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:[phone] 252-946-6481
(Serves:Carteret,Craven—south of the Neuse River,Onslow Fax:[phone]
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:[phone]
(Serves:Bertie,Camden,Chowan,Currituck, Dare,Gates,Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

S`°"' CAMA IA DREDGE & FILL No 85136 ABCD
GENERAL PERMIT Previous permit
Date previous permit issued - - -
n New n Modification Complete Reissue n 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:
15A NCAC ❑Rules attached. 0 General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#(_)
Email Subdivision
City ZIP
Affected I I CW n EW n PTA ❑ES I I PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): n OEA I I IHA n UW n SPIMA n PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no 11.
Type of Project/Activity / '6'
(Scale: )
Shoreline Length
--
Access Length I j i '- — I J '
i I i NI
(dock)length f t } I i
Fixed Platform(s) ---•--- r-- —.._.- �, I
1 _ r— -- — — --
Floating Platform(s) I i
1
Finger pier(s) I - _
j { — _
Total Platform areal i
-
Groin length/# I ——_ _ s _ /d. /fJA/
Bulkhead/Riprap length - -.— -
Avg distance offshore
Breakwater/Sill i ' �—
Max distance/length -
Basin,channel T_ —
Cubic yards I..___- —._ '......_...., --
Boat ramp I
j
Boathouse/Boatlift I
Beach Bulldozing_._ I
Other 1(
i,
j i • h 4 1
SAV observed: yes no I ? it L'''L
Moratorium: n/a yes no I • �.si a ) '^ r � i - -1-�
Site Photos: yes no a ..? , :?--4-"4'
Riparian Waiver Attached: yes ,no)i I--t 1'—^"*'�-_ -T I (_ ) I '
A building permit/zoning permit may be required by: %�
Permit Conditions TAR/PAM/NEUSE/BUFFER(circle one)
nSee note on back regarding River Basin rules
nSee additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

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 1=ax: 252-247-3330 252-946-6481
(Serves: Carteret, Craven—south of the Neuse River, Onslow Fax: [phone]
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: [phone]
(Serves: Bertie, Camden, Chowan, Currituck, Dare,Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

p°`'''''`�ry CAMA 7 DREDGE & FILL NO 85136 ABC D
GENERAL PERMIT Previous permit
J.
Date previous permit issued
New I I Modification I Complete Reissue 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:
I5A NCAC Rules attached. General Permit Rules available at the following link:www.deq.nc.gov/CAMArules
Applicant Name Authorized Agent
Address Project Location(County):
City State ZIP Street Address/State Road/Lot#(s)
Phone#( )
Email Subdivision
City ZIP
Affected I I CW EW n PTA 7 ES PTS Adj.Wtr.Body (nat/man/unk)
AEC(s): I I OEA I I IHA UW 7 SPIMA I I PWS Closest Maj.Wtr.Body
ORW:yes/no PNA:yes/no
Type of Project/Activity
(Scale: )
Shoreline Length
Access Length I 1t-
Pier(dock)length I 1 j
L
Fixed Platform(s) , .,
�■■.��■ I I r .
Floating Platform(s) I ,t iFinger pier(s) If!Total Platform areaPHIi I 111111 nil
Groin length/# 1111111111•11111111111111111111111 _'_ rMIIIIIIIMIIIIIIIIIIIIIIIIIIIIIMIIIIIIIIIIIIIBulkhead/Riprap length 11��R::: 111■1�1�■e1111�U■■■
Avg distance offshore �■.■�■■■.�
Brea kwater/Sill I ■■.�.■■■=
Max distance/length
...®.
_ _ iiiiiiiiiiii iiiii
Basin,channel
Cubic
yards
'_ ��®U . . . irmouritain III 11
Boat ramp INIMMI ®IIMINMEMI
Boathouse/Boatlift flhlIH! fffl
Beach Bulldozing
Other
11111■11.111111 IF
111111111111111111111111M11111111111EIMEMMIMIll
Moratorium:SAVyes no
yes no 111111011111 — __ ? i miiiniuiim
n/a
Site Photos: yes no
Riparian Waiver Attached: yes no I j 1
A building permit/zoning permit may be required by:
TAR/PAM/NEUSE/BUFFER(circle one)
Permit Conditions
II See note on back regarding River Basin rules
See additional notes/conditions on back
I AM AWARE OF STATUTES,CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name Permit Officer's PRINTED Name
Signature**Please read compliance statement on back of permit** Signature
Application Fee(s) Check#/Money Order Issuing Date Expiration Date

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: [phone] 252-946-6481
(Serves: Carteret,Craven—south of the Neuse River, Onslow Fax: [phone]
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: [phone]
(Serves: Bertie,Camden, Chowan, Currituck, Dare, Gates, Hertford, (Serves: Brunswick, New Hanover and Pender Counties)
Pasquotank and Perquimans Counties)
http://portal.ncdenr.org/web/cm/dcm-home Revised 6/01/2021

LAMA/ DREDGE & FILL VI (e i ce No. 73497
GENERAL PERMIT PreviousA B3 D
permit#
ew Modification Complete Reissue Partial Reissue Date previous permit issued
As authorized by the State of North Carolina,Department of Environmental Quality
and the Coastal Resources Commission in an area of environrrpeptal concern pursuant to 15A NCAC C//// / :s r)
C c;: y 7 Rules attached.
Applicant N �G(1n)) Co �ku—fy0 Ccrft.�- Project Location: County tat',,_ ' • ,. - _
Address _ 1- ' Box 77((, .-1- y Street Address/State Road/Lot#(s) 6R! 7ptL//�
City 82 brI O State N£ZIP q_9_, ' f9eatfla a1&
Phone# E-Mail ---------- -__-.-- Subdivision
Authorized Agent .---- City -_-_01 1 g i+J — — ZIP_ •
Affected "CW W If*A .K1S 7 PTS Phone# ( ) River Basin
❑OEA "HHF -IH O UBA - N/A
AEC(s): Adj.Wtr. Body JV g v 'j tin .
C PWS:
,�' Closest Maj.Wtr.Body. �_l5C5 —ORW: yes �c PNA yes /� }} i ' � /
Type of Project/Activity ) 4(' Lf"A ri l j i i (- ,, i C- `i V I f ;c, j c'_ taCt,,,f,'{)7 /
J �i Scale: !�f0
Pier(dock)length I / ' /
Fixed Platform(s) '4 7'cj �hQxp4•`
Floating Platform(s) w
Finger pier(s) —
Groin length _ l-_ . , .*St1�--- ly
number �---` V• ' _ L.
Bulkhead, ft_ / I III length y 1
avg distance offshore _r • } ���
max distance offshore -�0 N &c0(_; kf
Basin.channel `+
cubic yards ':
V
� I I ` i
Boat ramp
Boathouse/Boatlift ,r
Beachkkrzin _
Other_ "
-09) c‘SO-c-- —kr
Shoreline Length— f `*tr.:'Ai
SAV: not sure yes
Moratorium' n/a yes - �� �/, )
Photos: yes
N
411111911 �_
Waiver Attached: yes r<<� �r <<� — TLf1Y1, `!�`~ r�
A building permit may be required by: A f note on back regarding River Basin rules.
(Note Local Planning Jurisdiction
Notes/Special Conditions , _c` I`
tTe;">"1`0Vn4 -c)f,`}f .•n r. ;/4(4 sion s,
( ' (r‘if
SrLthl (---------
AaentoPrintedNsme { Perf' Officer's Printed
Sigire •; lease --••compliance statement on back of permit~ S
ApplicationFee(s) Check# I pure
g D e Expi on Date

N.C. DIVISION OF COASTAL MANAGEMENT
ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONIWAIVER FORM
CERTIFIED MAIL • RETURN RECEIPT REQUESTED or HAND DELIVERY
(Top portion to be completed by owner or their agent)
Name of Property Owner: Pamlico County
Address of Property: 681 Styrontown Beach Road, Oriental, NC
Mailing Address of Owner: PO Box 776, Bayboro, NC 28515
Owner's email: tim.buck(a)pamlicocountyorgv Owner's Phone#: [phone]
Agent's Name: Michelle Clements Agent Phone#: [phone]
Agent's Email: michelle.clementsPeastgroup.com
ADJACENT RIPARIAN PROPERTY OWNER'S CERTIFICATION
(Bottom portion to be completed by the Adiacent 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 943 Washington Square Mall, Washington, NC 27889. DCM representatives can also be
contacted at(252) 946-6481. 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.)
I DO wish to waive some/all of the 15'setback
Signature of Adjacent Riparian Property Owner
-OR-
I do not wish to waive the 15'setback requirement(initial the blank)
Signature of Adjacent Riparian Property Owner:
Typed/Printed name of ARPO:
Mailing Address of ARPO:
ARPO's email: ARPO's Phone#:
Date: *waiver is valid for up to one year from ARPO's Signature*
Revised July 2021

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,j•. ;4
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100m I :700'm�. '
500 ft• I•\ :'.' _ i 1500:H' yeT t
PIN: 6486563957000
Pamlico County, NC MAPID: 1092as.0
CALACRES: 2000E85949
This web site is being provided for the benefit of the general public. /1CRES: ,19.66 -
The entire risk associated with the use of this site is on the end ACCOUNT: 5470000
user.No representation is made that this web site will meet the OWNERJJAME STYRON FRANKER HERS
specific requirements of any person or will operate error-free or ,
without interruption.M other conditions or warranties,expressed OWNER_NAME2: WO CHARLIE S YRON
or implied are disclaimed.In no event will the County or Atlas OWE NER ADDR: w PO 80X 645 „ 1
Geographic Data,Inc.be liable for any loss of use,business OWNER.CITY: ORIENTAL
interruption,loss of profits,loss of data or.incidental/consequential OWNER_STAIE NC
damages arising from the use of this web site.The County and
Atlas Geographic Data,Inc.make no warranties or representations OWNER2IP: 28571
as to the accuracy of information on this web site,nor do they SITUS.ADDR: SIYRONTOWN BEACH RD •
assume any liability or responsibility for any errors or omissions in DEED_ACRES: 19.7
its content.It is the sole responsibility of the end user to evaluate pEEDYR: 19970101
the accuracy,completeness,or usefulness of any information, DEEDBOOK OD0000
opinion,advice,or other content available through this web site. 4
AEEDPAGE •0
�s141./`•- SALEDATE 1/ifl997
Qh1LLf(p•'
Q SALEAMT: '' 0 `
0.e.' LEGALDESC: END SR1310
148912
f'1t^=y +g1 B� LDG.,VAL: .25465 i
l' "' IAND_VAL•�s
N7ItrnY„- RDTALVAL.: .174377 I
CALC_ACRES: 18.1
Pamlico County,NC
202 Main Street
Bayboro,NC 28515

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a RRRIIII 1` xi -u' ' I(,lt`i W g;i I o. 2 ■ Complete Items 1,2,end r .,AI so complete a Signet
l.. r W ed g$ —,N ( ttem 4 If ResWcted Delivery Is desired. ` O Agent
non.....;nl r $ i - \ m I • PrIM your name and address on the reverse X MAVy,� LI Addressee
i, Q al ,t-, .o m — {j so that we can return the card to you, , , ,. C.Mt=,•t riflery
N i� _ ¢ p fn ■ Attach this card to the back of the,malipiece,
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oP ) < - D.le delivery address different from ttem 1? • Yes
�• '1.- �.;.,;r.��:, ,, ° D r 1. Moto Addressed to:kte
If YES,enter delivery address below: ❑No
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9.,� tl 4. Restricted Delivery?(ExtraFee) ❑Yes
i 2' ' 7018 2290 0001 9471 4007
I PS Form 3811,February 2004 Domestic Return Receipt 10 595-02M-1540
7018 2290 0001 9471 3994_ i . _— — —__
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1° � ■ Complete Items 1,2,and 3. A. Signature
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iI U — w-IT P n — o ■ Print your name and address on the reverse X El Agent
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�4-\ -i cii 6 04 G ° ' m °i • Attach this card to the back of the meilpiece, a Received by(Printed Name C.Date of Delivery
r' cc w i I cn fi d. o p (n or on the front If space permits. 4 -Z vaa•
cst I g i 1. Article Addressed to: D. Is delivery address different from Item 1? ❑Yes
a If YES,enter delivery address below: ❑No
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J: PS Pont,3811,July 2020 PSN 753002-0003o53 Domestic Return Receipt