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HomeMy WebLinkAboutSC_04-65_Town of Surf City3 WiRO for Surf Citv Local Government � 04-65 (' Permit Number LAMA 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 Statues, "Coastal Area Management" Issued to the Town of Surf City , authorizing development in Ocean Hazard Area of Environmental Concern AEC at 1605 N. Shore Drive as requested in the permittee's application, dated received December 1. 2003 . This permit, issued on December 15, 2003 , 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 the construction ofpicnic shelters, walkway, installing playground equipment and game areas and landscaping for a mini park located at 1605 N. Shore Drive, Surf City, NC. (1) All proposed development and associated construction must be done in accordance with the permitted work plat drawings(s) dated received Decemberl, 2003. (2) All work must conform to all local, State and Federal regulations. Contact Steve Padgett of Surf City for applicable local ordinances and FEMA Flood Regulations. (3) Any change or changes in the plans for development, or land use activities will require a re-evaluation and modification of this permit. (4) No disturbance shall occur within the 60 foot setback from the first line of stable vegetation. Conditions continued on second page This permit action may be appealed by the permittee or other qualified persons within twenty (20) days of the issuing date. From the date of an appeal, any work conducted under this permit must cease until the appeal is resolved. 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 furlher written permit approval. All work must cease when this permit expires on December 31, 2006 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. Local Permit Joanne Steenhufs CAMA Local Permit Official Wilmington Regional Office 127 Cardinal Drive Extension Wilmington, NC 284% / Permittee si Lure required 9 special conditions above apply to permit) Town of Surf City Minor Permit # 04 -65 December 15, 2003 Page Two (5) 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. _. (6) All disturbed areas shall be vegetatively planted and mulched within fourteen days of construction completion. (7) A copy of this permit shall be posted or available on site. Contact this office for a final inspection at completion of work. 910/395-3900. (8) Pursuant to 15A NCAC, Subchapter 7J.0406(b), this permit may not be assigned, transferred, sold or otherwise disposed of to a third -party. MINOR PERMIT NEW APPLICATION Applicant: Field Representative: J Received: Check #: beCeW, Public Notice: Date Published Comments Green Slips: )(; s+.Vl' PGA k, nj N. mEw KivFk oki-vE dd - �FIFMInm rI d C) COASTAL OF ADJACENT PROPERTY OWNER STATEMENT I hereby certify that I own property adjacent to Towki d f or f Cr -/ s (Name Of Property owner) property located at & OS /V. SAo�c Dvire. (Lot, Block, Road, etc.) on %osw,'l -TSr'aKol , in Su, -p r" I , ,N.C. They have described to me as shown below, the development they are proposing at that location, and, I have no objections to this proposal. DESCRIPTION AND/OR DRAWING OF PROPOSED DEVELOPMENT (To be idled in by individual proposing development) m;nI' - pork- L-/ PJc- QvourVj enL uir rnev 4h el yn,aI fl'c.n � stelfu.s / J ���e��� DEC 0 12003 DIVISION OF COASTAL MANAGEMENT Signature of Adjacent Owner Print or Type Name Telephone Number Date `/99Z uS Hwy Sz le l / D N vsi6 7 oaW sc,� /Y1 of lZ- C,,,,W Dr, me�,xf/ n/c, 2,-)So3 lyg L. M,n5`1 Sf, 2&c,joIf�/ NS 078�� C,�U, god pa ;s 2?33q Av�n Pe-lov) iPi. 0'Id PO: �+ Na,pska�) N(' 28yN3 ���IV DEC 0 1 2003 ED DIVISION OF COASTAL MANAGEMENT AEC HAZARD NOTICE Project Is In An: —4ZOcean Erodible Area High Hazard Flood Area Date Lot Was Platted: This notice is intended to make you, the applicant, aware of the special risks and conditions associated with development in this area, which is subject to natural hazards such as storms, erosion and currents. The rules of the Coastal Resources Commission require that you receive an AEC Hazard Notice and acknowledge that notice in writing before a permit for development can be issued. The Commission's rules onbuildingstandards, oceanfront setbacks and dune alteration are designed to minimize, but not eliminate, property loss from hazards. By granting permits, the Coastal Resources Commission does not guarantee the safety of the development and assumes no liability for future damage to the development. The best available information, as accepted by the Coastal Resources Commission, indicates that the annual ocean erosi n rate for the area where your property is located is feet per year. The rate was established by careful analysis of aerial photographs of the coastline taken over the past 50 years. Studies also 'indicate that the shoreline could move as much as feet landward in a major storm. The flood waters in a major storm are predicted to be about feet deep in this area. Preferred oceanfront protection measures are beach nourishment and relocation of threatened structures. Hard erosion control structures such as bulkheads, seawalls, revetments, groins, jetties and breakwaters are prohibited. Temporary devices, including sand bags, may be allowed under certain conditions. This structure shall be relocated or dismantled within two years of becoming imminently threatened. The applicant must acknowledge this information and requirements by signing this notice in the below space. Without the proper signatureoe application will not be r--19-d Date Inlet Hazard Area SPECIAL NOTE: This hazard notice is required for development in areas subject to sudden and massive storms and erosion. Permits issued for development in this area expire on December 31 of the third year following the year in which the permit was issued. Shortly before work begins on the project site, the Local Permit Officer will determine the vegetation line and setback distance at your site. If the property has seen little change and the proposed development can still meet the setback requirement, the LPO will inform you that you may begin work. It is impor- tant that you check with the LPO before the permit expires for official approval to continue the work after the permit has expired. Generally, if foundation pilings have been placed and substantial progress is continuing, permit renewal may not be necessary. If substantial progress has not been made, the permit must be renewed and a new setback line established. It is unlawful to continue work after permit expiration without this approval. For more information, contact: )9NnlE 57Er:�11lPQ/ Local Per t tfic r w/ rL 56tn� IT 15 OAKAIX)A l �1)r CXf Addre sue, IpM Locality Phone ,;,-o - 3y0a (0K'VS pCC012�3 DIVISION OF COASTAL MANAGEMENT Revised 11193 BEFORE YOU BUILD Setting Back for Safety: A Guide to Wise Development Along the Oceanfront When you build along the oceanfront you take a calculated risk. Natural forces of water and wind collide with tons of force, even on calm days. Man-made structures cannot be guaranteed to survive the force of a hurricane. Long-term erosion (or barrier island migration) may take from two to ten feet of the beach each year and, sooner or later, will threaten oceanfront struc- tures. These are the facts of life for oceanfront property owners. The Coastal Resources Commission (CRC) has adopted rules for building along the oceanfront. The rules are in- tended to avoid an unreasonable risk to life and property and to limit public and private losses from storms and long-term erosion. These rules lessen but do not eliminate the element of risk in oceanfront development. As you consider building along the oceanfront, the CRC wants you to understand the rules and the risks. With this knowledge you can make a more informed decision about where and how to build in the coastal area. The Rules When you build along the oceanfront, coastal manage- ment rules require that the structure be sited to fit safely into the beach environment. Structures along the oceanfront must be behind the frontal dune, landward of the crest of the primary dune and set back from the first line of natural stable vegetation a dis- tance equal to 30 times the annual erosion rate (a minimum of 60 feet). Large structures (multi -family residential struc- tures greater than 5,000 square feet and non-residential structures greater than 5,000 square feet) must be set back from the first line of natural stable vegetation a distance equal to 60 times the annual erosion rate or 120 feet, SETBACK SETBACK I FIRST LINE OF STABLE 60 x (7 (AVERAGE ALI ANNUALI NATURAL AVERAGE VEGETATION sap (EROSION I EROSION I IRATE I RATE DQo � I I I LAI LA RU�LL STRUCTURES) STRUCTURES) PERMITTED STRUCTURE; ADEQUATE SETBACK whichever is greater. If the erosion rate is greater than 3.5 feet/year, the setback is 30 times the erosion rate plus 105 feet. The Reasons The beachfront is an ever -changing landform. The beach and the dunes are natural "shock absorbers", taking the beatings of the winds and waves and protecting the inland areas. By setting back 30 or 60 times the annual long-term erosion rate, you have a good chance of enjoying the full life of the structure. At first, it seems very inviting to build your dream house as close to the beach as possible, but in five years you could find the dream has become a nightmare as high tides and storm tides threaten your investment. The Exception The Coastal Resources Commission recognized that these rules, initially passed in June of 1979, might prove a hardship for some property owners. Therefore, they estab- lished an exception for lots which cannot meet the setback requirement. The exception allows buildings in front of the setback line if the following conditions apply: (1) the lot must have been platted as of June 1, 1979, and not capable of being enlarged by combining with adjoining land under the same ownership, (2) development must be as far back on the property as possible and in no case less than 60 feet landward of the vegetation line, (3) no development can take place on the frontal dune (4) special construction standards on piling depth and square footage must be met and (5) all other CAMA, state and local regulations must be met. The exception is not available in the Inlet Hazard Area. To determine eligibility for the exception, the Local Permit Officer will make these measurements and observations: required setback from vegetation line exception setback (maximum feasible) rear property line setback max. allowable square footage on lowest floor lot area as calculated from vegetation line piling length needed to extend 4 feet below MSL PRE -PERMIT STRUCTURE; INADEQUATE SETBACK PRE -STORM BEACH PROFILE _� POST -STORM BEACH PROFILE ONE YEAR AFTER STORM/BEACH REBUILDING After the storm, the house on the dune will be gone. The other house has a much better chance of survival. SITE DRAWING/APPLICATION CHECKLIST Please make sure your site drawing includes the following information required for a CAMA minor development permit. The drawing may be simple and not necessarily to scale. The Local Permit Officer will help you, if requested. PHYSICAL DIMENSIONS Label roads Label highways right-of-ways Label local setback lines Label any and all structures and driveways currently existing on property PHYSICAL CHARACTERISTICS Draw and label mean high water mark Draw location of on -site wastewater system If you will be working in the ocean hazard area: Draw and label dune ridges (note height) Draw and label toe of dune Identify and locate first line of stable vegetation Draw and label setback line under CAMA Draw and label topographical features (optional) If you will be working in an estuarine shoreline area: Draw and label landward limit of AEC Describe terrain (slope) DEVELOPMENT PLANS Draw and label areas that will be disturbed If a house is to be placed on lot, describe location of house Note size of piling and depth to be placed in ground Draw and label all areas to be paved or graveled Describe composition of surface Note and list fully all trees and vegetation to be removed or relocated Show landscaping NOTE TO APPLICANT Have you: • completed all blanks and / or indicated if not applicable? • notified and listed adjacent property owners? • included your site drawing/ • signed both application and statement of ownership? • enclosed the $100.00 fee? • completed an AEC Hazard Notice, if necessary? FOR STAFF USE Site Notice Posted Final Inspection Fee Received Site Inspections �DFC4AST41 APPLICATION FOR CAMA MINOR DEVELOPMENT PERMIT In 1974, the North Carolina General Assembly passed the Coastal Area Management Act and sex the stage for id' and productive areas that border the scat tide nn1 n with requiring special care by those wh it an develop, the Ge r Assembly directed the Coastal Resourc omnd&og (VMto im le ment clear regulations that minimize t rden on the applicant. DIVISION OF This application for a minor developmdu£�ttut�Ptt�AICTA is part of the Commission's effort to meet the spirit and intent of the General Assembly. It has been designed to be straightforward and require no more time or effort necessary from the applicant. Please go over this folder with the Local Permit Officer (LPO) for the locality in which you plan to build to be certain that you understand whatinformation he or she needs. Under CAMA regulations, the minor permit is to be issued within 25 days once a complete application is in hand. Often less time is needed if i a the project is simple. The process generally takes about 18 days. You f canspeed the approval process by making certain that your application is complete and signed, that your drawing meets the specifications given inside and that your application fee is attached. Other permits are sometimes required for development in the coastal " 1 area. While these are not CAMA-related, we urge you to check with the Local Permit Officer to determine which of these you may need. A listing is included on page 2 of this folder. We appreciate your cooperation with the North Carolina Coastal Man- agement Program and your willingness to build in a way that protects the resources of our beautiful and productive coast. Coastal Resources Commission Division of Coastal Management Date of Action: Issued Revised 3/2003 Exempted Denied Appeal Deadline (20 days) Locality i Permit Number I Ocean Hazard Estuarine Shoreline ORW Shoreline _Public Trust Shorelines r (For official use only) GENERAL INFORMATION��9 O LAND OWNDER n r- n Address Z /V /V Mew /j: va ,r Q/i ✓e_ Gy City SL'e4 C. J.:o State NC- Zip Z 8 y`%s Phone 9/0-3ZP- 5/3/ AUTHORIZED AGENT Name '/4&Xza /Yoo/G Address PO Agar- Zy%S" City So' it C"Y� State NG Zip OS'`IVJ� Phone YW-32%- y/3/ LOCATION OF PROJECT. (Address, street name and/or directions to site. If not oceanfront, what is the name of the adjacentwaterbody?) 160 /1/60-7t4 S%ioye 4Nr-r/e— DESCRIPTION OF PROJECT: (List all proposed construction and land disturbance.) SIZE OF LOT/PARCEL- feet PROPOSED USE: Residential (Single-family _ Multi -family acres _) Commerical/Industrial Other TOTAL ENCLOSED FLOOR AREA OF A BUILDING IN THE OCEAN HAZARD AREA OF ENVI- RONMENTAL CONCERN (AEC): /28 square feet (includes all floors and roof -covered decks) SIZE OF BUILDING FOOTPRINT AND OTHER IMPERVIOUS OR BUILT -UPON SURER ES IN THE COASTAL SHORELINE AREA OF ENVIRONMENTAL CONCERN (AEC): sq. ft. (Calculations include the area of the roof/drip line of all buildings, driveways, covered decks, concrete or masonry patios, etc. that are within the applicable AEC. Attach your calculations with the project drawing.) Choose the AEC area that applies to your property- (1) within 75 feet of Normal High Water for the Estuarine Shoreline AEC (2) within 575 feet of Normal High Water for the Estuarine Shoreline AEC, adjacent to Outstanding Resource Waters (3) within 30 feet of the Public Trust Shoreline AEC (Contact your Local Permit Officer if you are not sure which AEC applies to your property.) STATE STORMWATER MANAGEMENT PERMIT: Is the project located in an area subject to a State Stormwater Man ent Permit issued by the N.C. Division of Water Quality? YES_ NO If yes, list the total built -upon area/impervious surface allowed for your lot or parcel. square feet. OTHER PERMITS MAY BE REQUIRED: The activity you are planning may require permits other than the CAMA minor development permit. As a service we have compiled a list of the kinds of permits that might be required. We suggest you check over the list with ,your LPO to determine if any of these apply to your project: Zoning, Drinking Water Well, Septic Tank (or other sanitary waste treatment system), Burning, Electrical, Plumbing, Heating and Air Conditioning, Insulation and Energy Conservation, FIA Certification, Sand Dune, Sediment Control, Subdivision Approval, Mobile Home Park Approval, Highway, Connection, and others. STATEMENT OF OWNERSHIP: I, the undersigned, an applicant for a CAMA minor development permit, being either the owner of property in an AEC or a person authorized to act as an agent for purposes of applying for a CAMA minor development permit, certify that the person listed as landowner on this application has a significant interest in the real property described therein. This interest can be described as: (check one) -Pe— an owner or record tide. Title is vested in , see Deed Book page in the County Registry of Deeds. an owner by virtue of inheritance. Applicant is an heir to the estate of , probate was in County. 9��q I if other interest, such as written contract or lease, explain below or use a ate ta aCt6M to th' a lication. �ACTAI hAANAGFIUFNT NOTIFICATION OF ADJACENT PROPERTY OWNERS: I furthermore certify that the following persons are owners of properties adjoining this property. I affirm that I have given ACTUAL NOTICE to each of them concerning my intent to develop this property and to apply for a CAMA permit. (I) (2) (3) (4) (Name) (Address) S1 C.e- 0-4-t&CL�-_4 FOR DEVELOPERS IN OCEAN HAZARD AND ESTUARINE HAZARD AREAS: I acknowledge that the land owner is aware that the proposed development is planned for an area which may be susceptible to erosion and/or flooding. I acknowledge that the local permit officer has explained to me the particular hazard problems associ- ated with this lot. This explanation was accompanied by recommendations concerning stabilization and floodproofing tech- niques. PERMISSION TO ENTER ON LAND: I furthermore certify that I am authorized to grant and do in fact grant permission to the local permit officer and his agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. This application includes: general information (this form), a site drawing as described on the back of this application, the ownership statement, the AEC hazard notice where necessary, a check for $100.00 made payable to the locality, and any infor- mation as may be provided orally by the applicant. The details of the application as described by these sources are incorporated without reference in any permit which may be issued. Deviation from these details will constitute a violation of any permit. Any person developing in an AEC without permit is subject to civil, criminal and administrative action. This the 17 day of JI[pd a mb4(J�ZaJ__ r Landowner or person authorized to act as his agent for purpose of filing a CAMA permit application. 4 7 y O Z UNITED STATES POSTAL SERVICE First -Class Mail Postage &fees Paid USPS Permit NQ. G-10 • Sender: Please print your name, address, and ZIP+4 in this box b ( ojLF75 A,K 21 IIIIIIIIIIfII11IlI!JIIIIJIIIJIIIIIJ31HIIIIIHIII IIIIIIIII ■ Complete items 1, 2, and 3. Also complete 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you.■ Attach this card to the back of the mailpieceor [A,item on the front if space pemtits. 1. Article Addressed to: NV. TLa o�. �O' kc, Agent Date of Deliver D. Is delivery address different from item 1? o Yes It YES, enter delivery address below: ❑ No 3. S ice Type rrvcertified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fero) ❑ Vert 2. Article 7002 2410 0007 1994 6181 (Trans{erfrom lrom service label) PS Form 3811, August 2001 Domestic Return Receipt 102595-02-AN5 UNITED STATES POSTAL SERVICE L II I Permit No. G-�D First -Class Postage & Fees Paid • Sender: Please print your name, address, and ZIP+4 in this box �o W fl &F 6 u,t�-' 61 J sly r� IN(, AFg45 rno+d mnImmr ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach thin card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: Mr. bao-n yer� -t�iaa lis �-Jw� g� 12i P1t t 01+ 451 �P B. Date of Delive lr i-2j-d3 ❑ Agent ❑ Addressl D. Is d ery ad different f m item 1? ❑ yes Iss fv�S, enter delivery address below: ❑ No 3. Service Type 4CCertified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandit ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? Xktra Fee) ❑ yes 2. Article Number (Copy from service label) 7002 2410 0007 1994 6150 PS Form 3811. Julv 1999 Domestic Return Receipt 102595-99A.1.179 Artified Mail Provides: zest-w-zd-seszoi r A mailing receipt (eve^oa) zooz eunr'ooss uuoj sa r A unique identifier for your mailpiace r A record of delivery kept by the Postal Service for two years t mportant Reminders: r Certified Mail may ONLY be combined with First -Class Mail® or Priority Malk r Certified Mail is not available for any class of international mail. y ii NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt mar be requested to Provide proof o' delivery. To obtain Return Receipt service, please complete antl attach a Retun Receipt (PS Form 3811) to the article and add applicable postage to cover IN fee. Endorse mailpiece "Return Receipt Requested". To receive afee waiver foi a duplicate return receipt, a USPSa postmark on your Certified Mail receipt b required. ■ For an additional fee, delivery may be restricted to the addressee o addressee's authorized agent. Advise the clerk or mark the meilpiece with thi endorsement "Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired, please present the arts cis at the post office for postmarking. If a postmark on the Certified Mai receipt is not needed, detach and affix label with postage and mail. MPORTANT: Save this receipt and present it when making an inquiry. Internet access to delivery InformAtin Is not available on mail addressed to APOs and Hoe. ��r a Postage $ - 37 ] CertlOed Fee ] 1 • � G l J Fee ] Rsem rm Required) (Entl Reemem Regairee �C �// � �� - ] 9 RerMMed DeliveryFee (Endorsement Required) / T U TMal Portage & Fees ,$ U ] II\ ant To - W� n /�/I aPo�n. 2ti( -I a ld b�ww 2d Ctly. SYefeZiP.1 f � aX q Lk3 :erlified Mail Provides: zaet-w-zo-seszol r A mailing receipt (as�anetl7 ZOOZ eun(•'ebeg uuoj Sc r A unique identifier for your mailpiece r A record of delivery kept by the Postal Service for two years rnportant Reminders: r Certified Mail may ONLY be combined with First -Class Maila or Priority Mailc r Certified Mail is not available for any class of international mail. i NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo valuables, please consider Insured or Registered Mail. r For an additional fee, a Return Receipt mar be requested to Provide proof of delivery. To obtain Return Receipt service, please complete antl attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece"Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS® postmark on your Certified Mail receipt iE required. r For an additional fee, delivery may be restricted to the addressee o addressee's authorized a9ant. Advise the clerk or mark the mailpiece with thr endorsement "Restricted Delivery". r If a postmark on the Certified Mail receipt is desired, please present the arti cis at the post office for postmarking. If a postmark on the Certified Mai receipt is not needed, detach and affix label with postage and mail. MPORTANT: Save thisleceipt and present It when making an inquiry. nternet access to delivery informAtin is not available on mail addressed to APOs and FPOs. Postage Certified Fee J — d— PosMadc 3 Retum Reaept Fae i re (Endorsement Requiretl) Rasirsenn Delivery Fee r (EMorsement Required) Total Postage BPass .$ u 7 ntTo Y " 7C ........... . - � --' certified Mail Provides: zest-N-zo-seszot ■ Amailing receipt (eveney) appy eunf'OOeE uaod Sid ■ A unique identifier for your mailpiecs ■ A record of delivery kept by the Postal Service for two years mportent Reminders: a Certified Mall may ONLY be combined with First -Class Mail® or Priority Maila Certified Mail is not available for any class of intemational mail. i NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Foi valuables, please consider Insured or Registered Mail. For an additional fee, a Return Receipt m% be requested to provide proof of delivery. To obtain Return Receipt service, please complete antl attach a Return Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver for a duplicate return receipt, a USPS® postmark on your Certified Mail receipt is required. For an additional fee, delivery may be restricted to the addressee of addressee's authorized agant. Advise the clerk or mark the mailpiece with the endorsement "ResMctedDelivery". . If a postmark on the Certified Mail receipt is desired, please present the art! cis at the post office for postmarking. If a postmark on the Certified Mai receipt is not needed, detach and affix Iebtl with postage and mail. MPONTANT: Save this receipt and present it when making an inquiry. oternet access to delivery Information is not available on mail addressed to APOs and FPOs. Postage I $ Certified Fear I llaspFas Postmark (Enct Iq.' ited) Here Restricted Deliveri, Fee (Endorsement Required) Total Postage & Fees I ZO U 3 sent TO 3 luf - &wn IOqcf5 --------------------------- ---- - ------------------------ ------------- orPOB=AFo. '4614 A US MWL)5;)L --------------- -------------------------- --- - --- -., ------------------------- City, State, Z1144 A I J45 IVT UNITED STATES POSTAL SERVICE II II I PePSINo. G-tDPaid • Sender: Please print your name, address, and ZIP+4 in this box I own 4(j Sut�' C�� a�75 dwcfs 2 % ItIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIII III IIIIIIIIII lilt IIIIII ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: A. Received by (Please Print Clearly) ��R. Date of Delive C. Signature X J% gent M�1r� LM Address D. Is delivery address different from Rem 1? ❑Yes If YES, enter delivery address below: ❑ No OAaunnr a-7� 3. Service Type � -Certified Mail O Express Mail ❑ Registered 0 Return Receipt for Merchandi ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extre Fee) ❑ Yes 2. Article Number (Copy from service label) 7002 2410 0007 1994 6167 PS Form 3811, July 1999 Domestic Return Receipt 102595-99-M-17I UNITED STATES POSTAL SERVICE 111 First-Class'Mail Postage 8, Fees Paid USPS Permit No. G-,10 • Sender: Please print your name, address, and ZIP+4 in this box be a� 75 PvWl A-ft: add % 111111113111111J11111IM1111111111111111111111111III III IIII ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print y6ur name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. Article Addressed to: IVN 6u� l41K W. Mures k. &O({u ijQ b-/%q X ❑ Agent ❑ Ad re7 B. Received by Punted Name) C. D of livery D. Is delivery address different from Rem 7 Yes If YES, enter delivery address below: ❑ No 3. Service Type Certified Mail ❑ Express Mail Registered ❑ Return Receipt for Merchandise O Insured Mal ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ yes 2. Article Number 7002 2410 0007 1994 6174 (Tiansler from service label) PS Form 3811, August 2001 Domestic Return Receipt 102595-02-M-1% Certified Mail Provides: zegt-w-zeseszo ■ A mailing receipt (eaenea) zooz eunr'ooee wod s, ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First -Class Mall, or Priority Mail ■ Certified Mail is notavailable for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fc valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt m% be requested to Provide Proof o delivery. To obtain ReturnReceipt servwe, please complete antl attach a Retur Receipt (PS Form 3811) to the article and add applicable postage to cover the fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver to a duplicate return receipt, a USPSe postmark on your Certified Mail receipt I,, required. ■ For an additional fee, delivery may be restricted to the addressee c addressee's authorized apant. Advise the clerk or mark the mailpiece with th endorsement "Restricted -Delivery". e If a postmark on the Certified Mail receipt is desired, please present the artl cle at the post office for postmarking. If a postmark on the Certified Me receipt is not needed, cl vach and affix label with postage and mail. MPORTANT: Save this receipt affd present it when making an Inquiry. Internet access to delivery information is not available on mail rddressed to APOs and FPOs. Postage I $ ] Certified Fee ] Postmark ] Retum Reclept Fee ,Here (Endorsement Required) ] Restricted De livery Fea i (Endorsement Required) r J I Total Postage 8 Fees ,$ J DaAWYI -------------------------d---------- «Po�MD. iii" -MaAc, CU tX ----- CM', State, Z,P C - r'l mm NG 0017SD,3 Certliled Mall Provides: aeet-w-ao-seszoi ■ A mailing receipt (eveney)= eunr•ooes uuoA s. ■ A unique Identifier for your mallplece ■ A record of delivery kept by the Postal Service for two years 'mportant Reminders: ■ Certified Mail may ONLY be combined with First -Class Maile or Priority Mail, ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo valuables, please consider Insured or Registered Mail. ■ For an additional fee, a Return Receipt mar be requested to provide proof o delivery. To obtain Return Receipt service, please complete antl attach a Returr Receipt (PS Form 3811) to the article and add applicable postage to cover thr fee. Endorse mailpiece "Return Receipt Requested". To receive a fee waiver foi a duplicate return receipt, a USPSe postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee o addressee's authorized agent. Advise the clerk or mark the mallpiece with IN endorsement 'Restricted Delivery. ■ If a postmark on the Certified Mail receipt is desired, ulease present the arti cleat the post office for postmarking. If a postmark on the Certified Mai receipt Is apt needed, detach and affix label with postage and mail. MPORTANT: Save this receipt and present it when making an inquiry. Internet access to delivery information Is not available on mall addressed to ill and FPOs. Postage I s , 37 Cortiffied Fee I Rolum Reciop, Fee --faemark Er dcrserttent Required) Hera Restricted OeWery Endorsement Required) Total Postage& Fees I Lt. 10", Sent To 3vw4-AjW7W ----------- VO-VA ------ KC ... . ......... W.P.0.8.0x*p.�� ----------- --------------------- Citv, State, ZIP+4 Utylayh IN -S 67609