20071612 Ver 1_Certified Return Receipt_20070929

^ Complete items t, 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.
Article Addressed to:
Mr. Charlie Stambaugh
1 178 Ocean Boulevard
Atlantic Beach, FL 32233
DWQ# 07-1612-Henderson
A.
Agent
(Printed Name) t~of
D. Is delivery address different from
If YES, enter delivery address b
3. S Ice Type
~Certlfied Mail
Registered
^ Insured Mail
4. Restricted DelivE
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^ Express ~b)ltl
Retum Receipt for Merchandise
C.O.D.
(Extra Fee) ^ Yes
2. ArtIcleNuml 7~p7 ],49p ppp3 562 3294
(Transfer from servr~e ,~,,
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED ST'4,T~~~~ir~`~-~`~{~'~'-dlC~ ~'r~ ,~:..
• Sender: Please print your name, address, and ZIP+4 in this box •
NC DENR Division of Water Quality
401 Oversight/Express Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
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