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HomeMy WebLinkAbout76457D - Wegener 'CLUD iz -x1020 :411 _ CAMA / DREDGE & FILL \-ftyl J No. 76457 A B C 0 GENERAL PERMIT Previous permit# )� [ New 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 environmental concern pursuant to I 5A NCAC • j ZOO ❑Rules attached. Applicant Name J CA VW S W Q Project Location: County IJEan1 Oath NW Address%;'15 oI&V\ OA k S V• Street Address/State Road/Lot#(s) 5"E4(ME City IN 1\Irn 1h State C. ZIP a$L} 1 Phone#( ) J E-Mail Subdivision Authorized Agent City \i1\VV\UPCD11 ZIP a.$t-1-U CW _,EW PTA ❑ES ❑PTS Phone# ( ) River Basin W1eN }C. OA k AEC(s):Affecte ❑OEA HHF ❑IH ❑UIBA ❑N/A Adj.Wtr. Body ?aCy Z" t`V 1 c-- ata /man /unkn) C PWS: ORW: yes /' no PNA ®/ no Closest Maj.Wtr. Body Al Wh/ Type of Project/Activity T 0 YIS'A-WIc.* P -Xtc( j>\ t,v 1 (OVe.v eck °e`t`b.'+ o - - Cie 1) - ((own 1LGrf G ,AAA 4 ‘ (Scale: ) Pier(dock)length gS '14 k.0i i Fixed Platform(s) (�) tZ0 f IU ?I/5►{L _ f Floating Platform(s) ,� Finger pier(s) I _ Groin length IHHII _ IIIHhIIIHIIhI®■■ ■ ■■••••• ■M. Bulkhead/Riprap length ■ •■ IHhllill avg distance offshore , lif e •/ max distance offshore 131111111111111111111 Basin,channel IIiIIIIIiI �' �� Q, cubic yards VjPNcCf���� --'�, ••lit •. uuuu������ ���� �uuu��� Boathouse/Boatlift • 1._ 'A mill ��� ZE TML EMIEM.����10.�.� ��� -r PI It ■••iiau• ••••uu� ••u•� 111111111111111111111111 Beach Bulldozing : 1111 / , Ia.- lipleji. , 1 - ? p Other / . Shoreline Length /--i LI t ' ! ' ihi .4, , . �, SAV: not sure yes 11hi TIOM - 1111 Moratorium: n/a yes g ot<,f_..__. ��� � ___. ; __ a' . Photos: es 'a w I•, II� _ 111 Waiver Attached: Q icol1 Oa c Dv A building permit may be required by: . n See note on back regarding River Basin rules. (Note Local Planning Jurisdiction) r .. -- Notes/Special Conditions Pt\\ l)Un' I S 7 kL 1 G H>n -c-e C00am`t VWA e S of p1-. t- Joir , -i-VVAv ,v‘k El ks Agent or Applicant Printed Name PermitOfficer's Printed Name G'k1� Signature * Please read compliance statement on back of permit** Signature a Ou.°J 3 I (1- t 1 I i 1- 1 1-0 3111- I a 1 Application Fee(s) Check it Issui Date Expiration Date 10/28/2020 09; 18 (FAX)9103437764 P,001/001 gEKTIfIED MAiL RETURN RECEIPT RE41 DIVISION OF COASTAL MANAGEMENT ADJACENT RIPARIAN PROPERTY OWNER NOTIFICATIONMIAIVER FORM Name of Property Owner: SEIM=)=RTH PAULSANDRA Address of Property: 815 SEVEN OAKS Dr (Lot or Street#, Street or Road, City & County) Agent's Name#: Lauren Orzechowski Mailing Address: 3012 STURFRIDGF CT Agent's phone#: 410-992-2656 ALLISON PARK PA 15101 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 descrption or drawing, with dimensions, must be provided with this letter, tr I have no objections to this proposal. I have objections to this proposal. If you have objections to what is being proposed,you must notify the Division of Coastal Management (DCM) in writing within 10 days of receipt of this notice. Contact information for DCM offices is available athttoJ/www.nccoa talma menLns1web/cm/staff-fisting orby calling 1-888-4RCOAST. Na response is coo ideasfihe Sam as no objection if you h y ievart tifietl1y Certified Mall. WAIVER'SECTION I understand that a pier, dock, mooring pilings, boat ramp, breakwater, boathouse, or lift must be set back a minimum distance of 15' from my area of riparian access unless waived by me. (If you Wish to waive the setback,.you must initial the appropriate blank below.) , RECEIVED do wish to waive the 15' setback requirement. NOV 0 3 207.0 f" I do not wish to waive the 15' setback requirement. DCM WILMINGTON, NC (Property Owner Information) (Ri arian Propert Owner information) Signature Signature Lauren Orzechowski 4t'D/ Print or Type Name Print or Type Name / 3805 Wrightsville Ave Ste. 15 1.%Af � ••"-. Mailing Address M!al 11 7g Address Wilmington,NC 28403IV:;/A;/1'?Al y\ I 4/C 44PM 11 City/State/Zip City/State/Z� 810-482-0001 Telephone Number/Email Address e ep one um er Email Address 10/22/2020 /1 ,Z 7/Lo SV Date Date ` (Revised Aug. 2014) 10993 :el N.C. DIVISION OF COASTAL MANAGEMENT NOTIFICATION OF COASTAL WETLAND DETERMINATION Pursuant to NCGS 113-229(n)(3), and 15A NCAC 07H.0205(a) A B C D .) Property Owner: )(‘AY'Ai Mailing Address: Site Address: `its G Project Location: County Ni ,AG US/NC/SR # River Basin ',AA, -\( ;)6. Adj. Water Body v Indicate Which of the Following Apply: Coastal Wetlands have been identified on the above described property. The project (as currently proposed) may impact these wetlands but no official delineation was performed. The Division of Coastal Management suggests that you request a formal delineation by this Division to evaluate potential impacts to Coastal Wetlands and project design alternatives. Coastal Wetlands have been identified on the above described property. At your request, an official Coastal Wetland delineation was performed by the Division of Coastal Management. The Division of Coastal Management suggests that you have the delineation surveyed. The Division will verify the surveyed line, which will then remain valid for a period not to exceed 12 months from the delineation. Coastal Wetlands species identified on-site: Spartina alterniflora Juncus roemerianus Salicornia spp. Distichlis spp. Limonium spp. Scirpus spp. Cladium jamaicense Typha spp. Spartina patens Spartina cynosuroides Check any field indicators that apply to establish regular or occasional flooding: tidal water observed on-site (do not check if during or following Tropical Storm/Hurricane) crabs/holes wrack lines staining tidal water connection periwinkle elevation changes other (please describe) DCM Official �_a,_f a`/ 14`^ Title ti < Date ( ‘ j J i In the event you wish to appeal this jurisdictional call, you may request a second opinion by contacting my supervisor, (DCM District Manager) at Visit our website at www.nccoastalmanagement.com • NO V 0 3 2020 NCDEQ VWLMINGTON;;,O November 3, 2020 Katharine Elks North Carolina Department of Environmental Quality Division of Coastal Management 127 Cardinal Drive Extension Wilmington, NC 28405 Katharine, On behalf of SEIFERTH PAUL SANDRA I would like to request a CAMA General Permit for their property located at 815 Seven Oaks Dr, Wilmington, New Hanover County. As shown on the attached figures, an 85' x 6' fixed pier is proposed. An 20' x 10' fixed platform and an 20' x 20' covered gazebo are included as well as a kayak launch step-down. No floating structures are proposed. A $200 fee check is attached.Adjacent riparian landowners have been notified by certified mail and the return receipts will be provided once they are received. Please let me know if you have questions or need anything in addition. I would be happy to meet you at the site at your convenience. Sincerely, Laumt, n o .ew Lauren Orzechowski Land Management Group, Inc. Enclosures: As stated Cc: SEIFERTH PAUL SANDRA RECEIVED NOV 0 3 2020 DCM WILMINGTON, NC www.Imgroup.net • Phone: 910.452.0001 • Fax: 910.452.0060 3805 Wrightsville Ave., Suite 15, Wilmington, NC 28403 AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION Name of Pr YOwner Requesting Permit: J01145 Z.,---Y4,1_e Mailing Address: ._ _CA ! c i U`› r_ t3i Ill Phone Number: Email Address: Goy ----- I certify that I have authorized Land M nagetnent Group Agent/Contractor to act on my behalf, for the purpose of applying for and obtaining all CAMA permits necessary for the following proposed development: pier and kayak launch at my property located at 815 Seven Oaks Drive in New Hanover County. I furthermore certify that I am authorized to grant, and do in fact grant permission to Division of Coastal Management staff, the Local Permit Officer and their agents to enter on the aforementioned lands in connection with evaluating information related to this permit application. Property Oner Infor`nation: Signature )0/ tti � Print or Type Name Title Date This certification is valid through 12 ,31 ,2021 RECEIVED NOV 0 3 2020 DCM WILMINGTON, NC RECEIVED NOV 032020 DCM WILMINGTON, NC BK: RB 6112 PG: 845-849 NC FEE$26.00 2017041777 RECORDED 12/2s�2o17 NEW HANOVER COUNTY, REAL ESTATE TAMMY THEUSCH BEASLEY 03:11:33 PM EXTX$660.00 REGISTER OF DEEDS BY ANDREA CRESWELL ASSISTANT ELECTRONICALLY RECORDED NORTH CAROLINA SPECIAL WARRANTY DEED THIS INSTRUMENT WAS PREPARED BY CHRISTOPHER H. ROEDE, ATTORNEY AT LAW, POYNER SPRUILL LLP, P. O. BOX 1801, RALEIGH, NC 27602-1801, WHO IS A LICENSED NORTH CAROLINA ATTORNEY. DELINQUENT TAXES, IF ANY, SHALL BE PAID BY THE CLOSING ATTORNEY TO THE COUNTY TAX COLLECTOR UPON DISBURSEMENT OF THE CLOSING PROCEEDS Return to: Collins and Collins *Without Title Examination* NORTH CAROLINA Parcel Identification Number: NEW HANOVER COUNTY R04500-001-009-000 Revenue: $660.00 Grantor states that the Property does not include the primary residence of Grantor. This Special Warranty Deed is made thisd•D'day of December, 2017, by and between XENTTH BANK, a Virginia state-chartered bank, formerly known as THE BANK OF HAMPTON ROADS, successor in interest to Gateway Bank & Trust Co., via merger ("Grantor"), whose mailing address is 901 East Cary Street, Suite 1700, Richmond, VA 23219, and PAUL SEIIFERTH and wife, SANDRA SE1t-ERTH ("Grantee"), whose mailing address is 3O 2. -- -0c1(>6 (.+. tkkki PA,. 13 The designations "Grantor" and "Grantee" as used herein shall include said parties, their heirs, successors, and assigns, and shall include singular, plural, masculine, feminine, or neuter as required by context. WITNESSETH: Submitted electronically by "Collins and Collins Law Offices, PLLC" in compliance with North Carolina statutes governing recordable documents and the terms of the submitter agreement with the New Hanover County Register of Deeds. GRANTEE HAS DETERMINED ON GRANTEE'S BEHALF (i) THE PHYSICAL CONDITION OF THE PROPERTY AND THAT THERE IS NO DEFECT OR CONDITION WHICH IS UNACCEPTABLE TO GRANTEE, (ii) WHETHER ANY PORTION OF THE PROPERTY LIES IN ANY FLOOD PLAIN, FLOOD WAY OR SPECIAL FLOOD HAZARD AREA, (iii) WHETHER ANY GEOLOGICAL FAULT OR UNSATISFACTORY SOIL CONDITION EXISTS ON ANY PORTION OF THE PROPERTY AND (iv) THAT ALL ENVIRONMENTAL CONDITIONS RELATING TO THE PROPERTY ARE ACCEPTABLE TO GRANTEE. In Witness Whereof, the Grantor has caused this instrument to be signed in its corporate name by its duly authorized officers, the day and year first above written. [SIGNATURES ON NEXT PAGE] RECEIVED NOV 0 3 2020 -3 - DCM WILMINGTON, NC EXHIBIT A LEGAL DESCRIPTION BEGINNING in the western edge of a 30 foot roadway which leads from the Middle Sound Road in a northeasterly direction across the C.N. Dunn Property to Pages Creek at a point where the Northeastern line of tract No. 8 intersects the western edge of said road and runs thence North 40 degrees 55 minutes East 219.3 feet with the western edge of said roadway to a stake, and thence North 59 degrees 30 minutes East 79.5 feet; thence North 42 degrees 40 minutes West 722.8 feet to a pine state in the edge of the marsh land of Pages Creek; thence up and with the meanders of said marsh land to a point from which the beginning point bears South 35 degrees 50 minutes East 1288 feet; thence with the dividing line between Tract Nos. 7 and 8 South 35 degrees 50 minutes East 1288 feet to the point of BEGINNING, being all of Lot No. 7 of the C.N. Dunn farm subdivision, as laid out and platted by J.L. Becton, Civil Engineer, said plat being recorded in the Office of the Register of Deeds for New Hanover County,North Carolina in Map Book No. 2 at Page 128. LESS AND EXCEPT THE FOLLOWING FROM THE ABOVE DESCRIBED TRACT: Tract One (1): Being all that property as shown on deed recorded in Book 1184, at Page 1873 of the New Hanover County Registry. Tract Two (2): Being all of that property as shown on deeds recorded in Book 1829, at Page 0805, and Book 2259, at Page 0087, of the New Hanover County Registry. Tract Three (3): Being all of that property as shown on deed recorded in Book 1968, Page 721, of the New Hanover County Registry. RECEIVED NOV 0 3 2G2G -5 - DCM WILMINGTON, NC DocuSign Envelope ID: DBD78F91-754F-4C73-A1A4-1092D9C3A682 OFFER TO PURCHASE AND CONTRACT-VACANT LOT/LAND [Consult"Guidelines"(form 12G)for guidance in completing this form] NOTE: This contract is intended for unimproved real property that Buyer will purchase only for personal use and does not have immediate plans to subdivide. It should not be used to sell property that is being subdivided unless the property has been platted, properly approved and recorded with the register of deeds as of the date of the contract. If Seller is Buyer's builder and the sale involves the construction of a new single family dwelling prior to closing, use the standard Offer to Purchase and Contract—New Construction (Form 800-T) or, if the construction is completed, use the Offer to Purchase and Contract (Form 2-T) with the New Construction Addendum(Form 2A3-T). For valuable consideration, the receipt and legal sufficiency of which are hereby acknowledged, Buyer offers to purchase and Seller upon acceptance agrees to sell and convey the Property on the terms and conditions of this Offer To Purchase and Contract and any addendum or modification made in accordance with its terms(together the"Contract"). 1. TERMS AND DEFINITIONS: The terms listed below shall have the respective meaning given them as set forth adjacent to each term. (a) "Seller":Paul D and Sandra G Seiferth (b) "Buyer": James D Wegener Jr,Valerie L Wegener (c) "Property": The Property shall include all that real estate described below together with all appurtenances thereto including the improvements located thereon. NOTE: If the Property will include a manufactured (mobile) home(s), Buyer and Seller should consider including the Manufactured(Mobile)Home provision in the Additional Provisions Addendum(Standard Form 2A1 1-T)with this offer. Street Address: 7419 Dunbar Road City:Wilmington Zip:28411 County:New Hanover ,North Carolina NOTE:Governmental authority over taxes,zoning,school districts,utilities and mail delivery may differ from address shown. Legal Description: (Complete ALL applicable) Plat Reference:Lot/Unit pt TR 7 ,Block/Section cn ,Subdivision/Condominium Dunn Place ,as shown on Plat Book/Slide at Page(s) The PIN/PID or other identification number of the Property is:316915741020000 Other description:PT TR 7 C N DUNN PLACE Some or all of the Property may be described in Deed Book 6112 at Page 845 (d) "Purchase Price": $ paid in U.S.Dollars upon the following terms: $ 500.00 BY DUE DILIGENCE FEE made payable and delivered to Seller by the Effective Date. 3,000.00 BY INITIAL EARNEST MONEY DEPOSIT made payable and delivered to Escrow Agent named in Paragraph 1(f)by ❑cash X personal check ❑official bank check ❑wire transfer, ❑electronic transfer,EITHER with this offer OR 0 within five(5)days of the Effective Date of this Contract. $ n/a BY(ADDITIONAL)EARNEST MONEY DEPOSIT made payable and delivered to Escrow Agent named in Paragraph 1(f) by cash, official bank check, wire transfer or electronic transfer no later than 5 p.m.on TIME BEING OF THE ESSENCE. n/a BY ASSUMPTION of the unpaid principal balance and all obligations of Seller on the existing loan(s) secured by a deed of trust on the Property in accordance with the attached Loan Assumption Addendum(Standard Form 2A6-T). $ n/a BY SELLER FINANCING in accordance with the attached Seller Financing Addendum (Standard Form 2A5-T). $ BALANCE of the Purchase Price in cash at Settlement (some or all of which may be paid with the proceeds of a new loan). Page 1 of 12 This form jointly approved by: STAIME3 12-T North Carolina Bar Association os DS Revised 7/2019 REALTORa North Carolina�Association of REALTOR� c. SGS rOPPORTUNITY N O V 0 3 2007/2019 Buyer initials ' l V( Seller initials T �,/l�J iIlueCuast Realty Corporation,575 Military Cutoff Road STE 200 Wilmington,NC 28405 Phone:(910)297-3835 FiN319 W?EM I N G9Oitl''afitdh Janet('ronemiller Produced with zlpForm®by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48028 www,iol ogle cord I V uucuaiyn envelope iu:u13u/SF91-754F-4C73-A1A4-1092D9C3A682 documents,including assignment of this Contract in connection therewith,at no cost to the non-exchanging party, as shall be required to give effect to this provision. 14. PARTIES: This Contract shall be binding upon and shall inure to the benefit of Buyer and Seller and their respective heirs, successors and assigns. As used herein, words in the singular include the plural and the masculine includes the feminine and neuter genders,as appropriate. 15. SURVIVAL: If any provision herein contained which by its nature and effect is required to be observed,kept or performed after the Closing,it shall survive the Closing and remain binding upon and for the benefit of the parties hereto until fully observed,kept or performed. 16. ENTIRE AGREEMENT: This Contract contains the entire agreement of the parties and there are no representations, inducements or other provisions other than those expressed herein.All changes, additions or deletions hereto must be in writing and signed by all parties. Nothing contained herein shall alter any agreement between a REALTOR® or broker and Seller or Buyer as contained in any listing agreement,buyer agency agreement,or any other agency agreement between them. 17. CONDUCT OF TRANSACTION: The parties agree that any action between them relating to the transaction contemplated by this Contract may be conducted by electronic means, including the signing of this Contract by one or more of them and any notice or communication given in connection with this Contract. Any written notice or communication may be transmitted to any mailing address, e-mail address or fax number set forth in the"Notice Information" section below. Any notice or communication to be given to a party herein, any any fee, deposit of other payment to be delivered to a party herein,may be given to the party or to such party's agent. Seller and Buyer agree that the "Notice Information" and "Acknowledgment of Receipt of Monies" sections below shall not constitute a material part of this Contract, and that the addition or modification of any information therein shall not constitute a rejection of an offer or the creation of a counter offer. 18. EXECUTION: This Contract may be signed in multiple originals or counterparts, all of which together constitute one and the same instrument. 19. COMPUTATION OF DAYS/TIME OF DAY:Unless otherwise provided, for purposes of this Contract, the term "days" shall mean consecutive calendar days, including Saturdays, Sundays, and holidays, whether federal, state, local or religious. For the purposes of calculating days,the count of"days" hall begin on the day following the day upon which any act or notice as provided in this Contract was required to be performed or made.Any reference to a date or time of day shall refer to the date and/or time of day in the State of North Carolina. THE NORTH CAROLINA ASSOCIATION OF REALTORS®, INC. AND THE NORTH CAROLINA BAR ASSOCIATION MAKE NO REPRESENTATION AS TO THE LEGAL VALIDITY OR ADEQUACY OF ANY PROVISION OF THIS FORM IN ANY SPECIFIC TRANSACTION. IF YOU DO NOT UNDERSTAND THIS FORM OR FEEL THAT IT DOES NOT PROVIDE FOR YOUR LEGAL NEEDS, YOU SHOULD CONSULT A NORTH CAROLINA REAL ESTATE ATTORNEY BEFORE YOU SIGN IT. This offer shall become a binding contract on the Effective Date. Unless specifically provided otherwise, Buyer's failure to timely deliver any fee, deposit or other payment provided for herein shall not prevent this offer from becoming a binding contract,provided that any such failure shall give Seller certain rights to terminate the contras cry flier in,Qr as otherwise permitted by law. Date: 9/6/2020 Da L.P . S-u ` �— Buyer �v"�- F77E769685C04B6... 9/7/2020 I 8:39 AM EDT Seller \-jaliiVrIVWegener Jr Paul D and Sandra G Seiferth Date: 9/6/2020 Date: 9/7/2020 I 8:37 AM EDT -nor.uSignrri by- Buyer Val tor, Seller t �V'd1 'EF°Wegener �altii ira ... S�t�t Vtu —C455087804084BE... Entity Buyer: Entity Seller: (Name of LLC/Corporation/Partnership/Trust/etc.) (Name of LLC/Corporation/Partnership/Trust/etc.) By: By: Name: Name: Title: Title: Date: RECEIVED Date: Page 9 of 12 NOV 0 3 2020 STANDARD FORM 12-T Revised 7/2019 ©7/2019 DC M WIWILMINGTONrobJQwith zipForm®by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48026 www z of oyix corn 7419 Dunbar vovrorui-io4+r-4t,/o-Ahck4-iuvzu9G3A682 NOTICE INFORMATION NOTE: INSERT AT LEAST ONE ADDRESS AND/OR ELECTRONIC DELIVERY ADDRESS EACH PARTY AND AGENT APPROVES FOR '11 E RECEIPT OF ANY NOTICE CONTEMPLATED BY THIS CONTRACT. INSERT "N/A" FOR ANY WHICH ARE NOT APPROVED. BUYER NOTICE ADDRESS: SELLER NOTICE ADDRESS: Mailing Address: Mailing Address: Buyer Fax#: Seller Fax#: Buyer E-mail: Seller E-mail: CONFIRMATION OF AGENCY/NOTICE ADDRESSES Selling Firm Name: BlueCoast REalty Listing Firm Name:Intracoastal Realty Corp Acting as❑X Buyer's Agent j Seller's(sub)Agent❑Dual Agent Acting as XQ Seller's Agent Q Dual Agent Finn License#: c211662 Firm License#: C2062 Mailing Address: 575 Military Cutoff Rd,Wilmington,NC Mailing Address: 1900 Eastwood Road,Suite 38, 28405-8702 Wilmington,NC 28403-0505 Individual Selling Agent:Janet Cronemiller Individual Listing Agent: Jane Dodd Acting as a Designated Dual Agent(check only if applicable) 0 Acting as a Designated Dual Agent(check only if applicable) Selling Agent License#: 228352 Listing Agent License#: 124935 Selling Agent Phone#: (910)297-38335 Listing Agent Phone#:(910)617-3208 Selling Agent Fax#: Listing Agent Fax#: (678)552-2307 Selling Agent E-mail:janet@wilmingtonnchomes.coms Listing Agent E-mail:janedodd@intracoastalrealty.com [THIS SPACE INTENTIONALLY LEFT BLANK] RECEIVED NOV 03 20 DCM WILMINGTON, NC Page 11 of 12 ADS STANDARD FORM 12-T (2 Revised 7/2019 l Buyer initials V i W Seller initials S ©7/2019 Produced with zipForm®by zipLogix 18070 Fifteen Mile Road,Fraser,Michigan 48026 yvww-zjpLoaix corm 7419 Dunbar 3. g SENDER' COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY s E A. Signature ■ Complete items 1,2,and 3. 3 ■ Print your name and address on the reverse X 0 Agent so that we can return the card to you. ^ 0 Addressee " ■ Attach this card to the back of the mailpiece, B. Receivedby(Printed Nam C. Date.f Delive, or on the front if space permits. - , �-C cti Jr/ I ) ` l'J It) • 49 • Y m m m ' 1. Article Addressed to: D. Is delivery address different from item 1? ►i Yes IA, -will h t CIA(I If YES,enter delivery address below: ❑No k4"1 t 2- CfQS5WIYlSV. I m i ,73 U (I I'll'I III11111 IIII 111111111111111 1111 3. Service Type 0 Reggi ty Mail Express® 80 Adult Signature 0 Registered Mail'`" i. ❑Adult Sig nature Restricted Delivery ❑Registered Mail Restricted 0 9590 9402 6103 0209 9820 11 $Certified Mail® Delivery d U 0 Certified Mail Restricted Delivery 0 Return Receipt for z 0 Collect on Delivery Merchandise Lri o ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation,. 2. Article Number(Transfer from service label) 1-1Ina,uPd Mail ❑Signature Confirmation 0 0 o u m o 'i Mail Restricted Delivery Restricted Delivery 7018PiPWA 1130 0001 7930 6403 500> o == PS Form 3811,July 2015 PSN 7530-02-000-9053 1.0 Domestic Return Receipt aaa=_ a 000 ,000 m N§ n a� U E i g m LL mm2 Q, mmm m 2if x Nm O . , L 2n- �o try mf m $ 33J o' 142 nm oil yd o 0 . U a o 0 u U K E •_ 2 ao , ta)2 c 7 8 m m° 65 C c U 28 r ± ah UU` atU 2m d 0 m n 8 s 3 a 00 8 NEE os • E m O