20120575 Ver 1_401 Application_20120612

Martin Marietta Materials
Greensboro District
413 S Chimney Rock Road
Greensboro NC 27409
Telephone [phone]
Fax [phone]
June 4 2012
Mr Steve Kichefski
United States Corp of Engineers - Wilmington District
Asheville Regulatory Field Office
151 Patton Ave Room 208
Asheville NC 28801 -5006
Re PCN Notification for Proposed Pipe Replacements
Martin Marietta s Bakers Quarry
Dear Mr Kichefski
201205 �5
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
7010 1670 0000 5792 2146
COURTESY
CnOpy
Please find attached a PCN Notification to replace three (3) individual pipes consisting of 18
36 and 48'm diameter (installed side -by -side) with three (3) new 42 CMP s (installed side -
by -side) The existing pipes are approximately 30 m length The proposed new pipes will be
60 to length These new pipes will allow for the replacement of the old rusted pipes but will
also provide a safer access across the unnamed tributary of Stevens Creek at Martin Marietta s
Bakers Quarry
We believe that tlus project will also improve stream characteristics within the channel itself by
eliminating the amount of debris and sediment that has accumulated over time thus creating
more of an impoundment within the stream channel rather than a natural flowing stream
Seeing the proposed stream impact is less that 150 the PCN is being submitted to the North
Carolina DWQ401 Wetlands Units for information only Tlus information should meet with
your approval If you have any questions please contact me at (336) 389 -6616 or e-mail me at
bean north@marhnmanetta com
S erely
o�
Brian K North PE
Division Environmental Manager
� =o
e
JUN 7
DENR
2012
ma_ W.141_ - 1
y
cc NC DWQ 401 Wetlands Unit (Certified Mail 7010 1670 0000 5792 2139)

Attachments
Figure I — USGS Quad Map (Bakers Quad)
Figure 2 — Aerial (Union County GIS)
Figure 3 — Soils map (Umon County GIS)
Figure 4 — Mme Map showing existing and proposed pipe locations
Figure S — Mme Map Insert
Figure 6 — Typical Roadway Crossing Detail
Figure 7 — Google Earth map of proposed project
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Office Use Only
Corps action ID no
DWQ project no
Form Version 13 Dec 10 2008
Page 1 of 13
PCN Form — Version 13 December 10 2008 Version
Pre - Construction Notification CN) Form
A Applicant Information
1
Processing
1 a
Type(s) of approval sought from the
Corps
Section
on 404 Permit Section 10 Permit
1 b Specify Nationwide Permit (NWP) number NWP 39 or General Permit (GP) number
I c
Has the NWP or GP number been verified by the Corps?
® Yes ❑ No
Id
Type(s) of approval sought from the DWQ (check all that apply)
❑ 401 Water Quality Certification — Regular ❑ Non 404 Jurisdictional General Permit
[:1401 Water Quality Certification — Express ❑ Riparian Buffer Authorization
1 e
Is this notification solely for the record
because written approval is not required?
For the record only for DWQ 401
Certification
® Yes ❑ No
For the record only for Corps Permit
® Yes ❑ No
If
Is payment into a mitigation bank or in lieu fee program proposed for mitigation
of impacts? If so attach the acceptance letter from mitigation bank or in lieu
fee program
❑ Yes ® No
1 g
Is the project located in any of NC s twenty coastal counties If yes answer 1 h
below
❑ Yes ® No
1 h Is the project located within a NC DCM Area of Environmental Concern (AEC)?
❑ Yes ® No
2
Project Information
2a
Name of project
Proposed mainteance of existing stream crossing and replacement with pipe
extensions on an unnamed tributary to Stevens Creek at Martin Marietta s Bakers
Quarry located in Monroe NC
2b
County
Union
2c
Nearest municipality / town
Monroe
2d
Subdivision name
2e
NCDOT only T I P or state
project no
3
Owner Information
3a
Name(s) on Recorded Deed
Martin Marietta Materials Inc
3b
Deed Book and Page No
DB 4719 PG 422
3c
Responsible Party (for LLC if
applicable)
3d
Street address
2710 Wycliff Road (P O Box 30013)
3e
City state zip
Raleigh NC 27607 3013 (Raleigh NC 27622 0013)
3f
Telephone no
336 389 -6616
39
Fax no
336 -605 3628
3h
Email address
bnan north @mardnmanetta com
Page 1 of 13
PCN Form — Version 13 December 10 2008 Version

4 Applicant Information (if different from owner)
4a Applicant is
❑ Agent ❑ Other specify
4b Name
4c Business name
(if applicable)
4d Street address
4e City state zip
4f Telephone no
4g Fax no
4h Email address
5 Agent/Consultant Information (if applicable)
5a Name
5b Business name
(if applicable)
5c Street address
5d City state zip
5e Telephone no
5f Fax no
5g Email address
Page 2 of 13
PCN Form — Version 1 3 December 10 2008 Version

B
Project Information and Prior Project History
1
Property Identification
1 a
Property identification no (tax PIN or parcel ID)
Tax Parcel ID 09339020C
1 b
Site coordinates (in decimal degrees)
Latitude 35 0170 Longitude 80 36 25
(DD DDDDDD) (DD DDDDDD)
91 10 acres on this individual parcel (However Martin
1 c
Properly size
Marietta owns a total of 305 91 acres that make up this
quarry location) acres
2
Surface Waters
2a
Name of nearest body of water (stream river etc ) to
Stevens Creek
proposed project
2b
Water Quality Classification of nearest receiving water
C
--t[2c River basin
Yadlcn
Page 3 of 13
PCN Form — Version 13 December 10 2008 Version

3
Project Description
3a
Describe the existing conditions on the site and the general land use in the vicinity of the project at the time of this
application
This operation is a slate quarry which consists of mining and extraction of the native material The quarry is located north
of the City of Monroe The general use within the vicinity of the quarry is mixed industrial with some commercial
3b
List the total estimated acreage of all existing wetlands on the property
+/ 5 0 acres primarily associated with the two natural impoundments on the property
3c List the total estimated linear feet of all existing streams (intermittent and perennial) on the property
+/ 1850 feet
3d
Explain the purpose of the proposed project
The proposed project is necessary to replace the three (3) existing 18 36 amd 48 pipes (approximately 30 long and
installed side by side) that carry the flow of the existing tributary of Stevens Creek These pipes have been installed
since the early years of the quarry operation which opened in 1949 The pipes have rusted out while sediment and
woody debris has obstructed the flow of the channel creating more of an impoundment rather than the flow of an actual
stream It is our desire to not only replace the existing pipes but also re locate the pipes approximately +/ 10 to 20
upstream and extend the lengths of the pipes to allow for a safer passage across the stream with loaded quarry vehicles
The proposed pipes have been designed as three (3) 42 CMP s to carry the expected design storm The length of the
proposed pipes (installed side by side) will be 60 long This will be an increase of 30 from the orginal length of pipes
currently in use
The new crossing will serve as a direct access roadway across the tributary of Stevens Creek to dispose of tailings
material into the existing quarry pit Since the settling cells are located adjacent to the tributary this new access will
eliminate the safety concerns that currently exists for loaded haul trucks to travel along the pit wall to dispose of the
generated tailings waste from the operation Currently the tailings are loaded into quarry haul trucks and are transported
through the plant and then along a narrow roadway adjacent to the high wall of the pit This roadway is difficult for these
large trucks to manuver and safely dispose of the material The new access will provide a wider crossing to transport this
material which will eliminate the safety issues that currently exists Once the old pipes are removed and the new pipes
are installed the banks will be stabilized
3e
Describe the overall project in detail including the type of equipment to be used
The project will include the removal of three existing culverts that are located in a tributary of Stevens Creek at Martin
Marietta s Bakers Quarry The existing pipes are located side by side and have diameters of 18 36 and 48 Their
length is approximately 30 long It is our desire to remove these old pipes and install three new 42 CMP pipes (installed
side by side) approximately 10 to 20 upstream of the existing pipes The lengths of the new pipes will be 60 long On
site backhoes and excavators will be used to remove the old pipes and install the new ones The new pipes will serve as
an access across this tibutary which will allow a direct access to dispose of quarry tailings directly into the quarry pit
This new access will eliminate an existing safety concren of loaded haul trucks transporting this material along a narrow
roadway adjacent to the quarry high wall Permanent stabilization will be provided on all of the exposed areas
immediately upon completion of the project This project will require approval from the NC Division of Land Resources
Land Quality Section in compliance with the NC Mining Act
4
Jurisdictional Determinations
4a
Have jurisdictional wetland or stream determinations by the
Corps or State been requested or obtained for this property /
project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
Comments A NC Stream ID has been completed by Martin
Marietta sraff
4b
If the Corps made the jurisdictional determination what type
❑ Preliminary ❑ Final
of determination was made?
4c
If yes who delineated the jurisdictional areas?
Agency /Consultant Company
Name (if known)
Other
4d
If yes list the dates of the Corps jurisdictional determinations or State determinations and attach documentation
Page 4 of 13
PCN Form —Version 1 3 December 10 2008 Version

6 Project History
5a Have permits or certifications been requested or obtained for
this project (including all prior phases) in the past?
❑ Yes ® No ❑ Unknown
5b If yes explain in detail according to help file instructions
6 Future Project Plans
6a Is this a phased project?
❑ Yes ® No
6b If yes explain
Page 5 of 13
PCN Form —Version 1 3 December 10 2008 Version

C Proposed Impacts Inventory
1 Impacts Summary
la Which sections were completed below for your project (check all that apply)
❑ Wetlands ® Streams tributaries ❑ Buffers
❑ Open Waters ❑ Pond Construction
2 Wetland Impacts
If there are wetland impacts proposed on the site then complete this question for each wetland area impacted
2a
2b
2c
2d
2e
2f
Wetland impact
Type of jurisdiction
number —
Type of impact
Type of wetland
Forested
(Corps 404 10
Area of impact
Permanent (P) or
(if known)
DWQ — non -404 other)
(acres)
Temporary
W1 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W2 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W3 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W4 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W5 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
W6 ❑ P ❑ T
❑ Yes
❑ Corps
❑ No
❑ DWQ
2g Total wetland impacts
2h Comments
3 Stream Impacts
If there are perennial or intermittent stream impacts (including temporary impacts) proposed on the site then complete this
question for all stream sites impacted
3a
3b
3c
3d
3e
3f
3g
Stream impact
Type of impact
Stream name
Perennial
Type of jurisdiction
Average
Impact
number
(PER) or
(Corps 404 10
stream
length
Permanent (P) or
intermittent
DWQ — non -404
width
(linear
Temporary M
(INT)?
other)
(feet)
feet)
S1 ®P ❑ T
Culverts Fill
Unnamed tributary
® PER
❑ Corps
10
60
of Stewart Creek
❑ INT
❑ DWQ
S2 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S3 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S4 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S5 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
S6 ❑ P ❑ T
❑ PER
❑ Corps
❑ INT
❑ DWQ
3h Total stream and tributary impacts
60
31 Comments 30 of old culvert impacts will be replaced with 60 of new culvert impacts
Page 6of13
PCN Form —Version 1 3 December 10 2008 Version

4 Open Water Impacts
If there are proposed impacts to lakes ponds estuaries tributaries sounds the Atlantic Ocean or any other open water of
the U S then individually list all open water impacts below
4a
4b
4c
4d
4e
Open water
Name of waterbody
impact number —
(if applicable)
Type of impact
Waterbody type
Area of impact (acres)
Permanent (P) or
Temporary
01 ❑P ❑T
02 ❑P ❑T
03 ❑P ❑T
04 ❑P ❑T
4f Total open water impacts
4g Comments
6 Pond or Lake Construction
If pond or lake construction proposed then complete the chart below
5a
5b
5c
5d
5e
Wetland Impacts (acres)
Stream Impacts (feet)
Upland
Pond ID
Proposed use or purpose
(acres)
number
of pond
Flooded
Filled
Excavated
Flooded
Filled
Excavated
Flooded
P1
P2
5f Total
5g Comments
5h Is a dam high hazard permit required?
❑ Yes ❑ No If yes permit ID no
51 Expected pond surface area (acres)
5j Size of pond watershed (acres)
5k Method of construction
6 Buffer Impacts (for DWQ)
If project will impact a protected npanan buffer then complete the chart below If yes then individually list all buffer impacts
below If any impacts require mitigation then you MUST fill out Section D of this form
6a
❑ Neuse ❑ Tar Pamlico ® Other Yadkin
Project is in which protected basin?
❑ Catawba ❑ Randleman
6b
6c
6d
6e
6f
6g
Buffer impact
number —
Reason
Buffer
Zone 1 impact
Zone 2 impact
Permanent (P) or
for
Stream name
mitigation
(square feet)
(square feet)
Temporary
im act
required?
B1 ❑P ❑T
El Yes
❑ No
B2 ❑P ❑T
El Yes
❑ No
B3 ❑P ❑T
El Yes
❑ No
6h Total buffer impacts
61 Comments
Page 7of13
PCN Form —Version 13 December 10 2008 Version

D Impact Justification and Mitigation
1 Avoidance and Minimization
1 a Specifically describe measures taken to avoid or minimize the proposed impacts in designing project
Martin Marietta proposes to remove three old existng culverts in a tributary of Stevens Creek at the Bakers Quarry These
culverts have rusted out and over time material has accumulated within the channel to form more of an impoundment than a
flowing stream It is our desire to replace these culverts with three new 42 CMP pipes providing additional discharge
capacity within the stream channel and to restore the characteristics of a typical stream In addition we would like to use the
pipe replacement project as a roadway access project to eliminate a safety hazard that exists within the quarry It is our desire
to reduce the amount of hard impact (pipe) to this tributary by replacing an existing crossing that is in need of much repair
rather than adding an additional hard impact for a proposed roadway crossing We believe that by replacing the existing pipes
with larger diameter pipes we will be able to improve the flow characteristics of the channel while providing a safe passage of
loaded haul trucks to dispose of waste material generated in the mining process In addition this project is outside of any
regulated FEMA floodway or floodplains
1 b Specifically describe measures taken to avoid or minimize the proposed impacts through construction techniques
Once approval has been obtained from the Division of Land Resources Land Quality Section and prior to the land clearing
phase the clearing limits for the pipe replacements shall be flagged Proir to land clearing erosion and sediment control
devices will be installed to maintain water quality of the unnamed tributary Once removal and installation of the pipes is
finalized and construction activities have been completed the area shall be seeded and stabilized to prevent erosion and
sedimentation A 50 wide natural buffer will be maintained along the remaining length of the unnamed tributary that traverses
through the property as required by the conditions of our NC mining permit
2 Compensatory Mitigation for Impacts to Waters of the U S or Waters of the State
2a Does the project require Compensatory Mitigation for
❑ Yes ® No
impacts to Waters of the U S or Waters of the State?
2b If yes mitigation is required by (check all that apply)
❑ DWQ ❑ Corps
❑ Mitigation bank
2c If yes which mitigation option will be used for this
El Payment to in lieu fee program
project?
❑ Permittee Responsible Mitigation
3 Complete if Using a Mitigation Bank
3a Name of Mitigation Bank
3b Credits Purchased (attach receipt and letter)
Type
Quantity
3c Comments
4 Complete if Making a Payment to In lieu Fee Program
4a Approval letter from in lieu fee program is attached
❑ Yes
4b Stream mitigation requested
linear feet
4c If using stream mitigation stream temperature
❑ warm ❑ cool ❑cold
4d Buffer mitigation requested (DWQ only)
square feet
4e Riparian wetland mitigation requested
acres
4f Non riparian wetland mitigation requested
acres
4g Coastal (tidal) wetland mitigation requested
acres
4h Comments
5 Complete if Using a Permittee Responsible Mitigation Plan
Page 8 of 13
PCN Form — Version 1 3 December 10 2008 Version

5a If using a permittee responsible mitigation plan provide a descnption of the proposed mitigation plan
6 Buffer Mitigation (State Regulated Riparian Buffer Rules) — required by DWO
6a Will the project result in an impact within a protected npanan buffer that requires
buffer mitigation?
❑ Yes ® No
6b If yes then identify the square feet of impact to each zone of the riparian buffer that requires mitigation Calculate the
amount of mitigation required
Zone
6c
Reason for impact
6d
Total impact
(square feet)
Multiplier
6e
Required mitigation
(square feet)
Zone 1
3 (2 for Catawba)
Zone 2
1 5
6f Total buffer mitigation required
6g If buffer mitigation is required discuss what type of mitigaton is proposed (e g payment to private mitigation bank
permittee responsible riparian buffer restoration payment into an approved in lieu fee fund)
6h Comments
Page 9 of 13
PCN Form — Version 13 December 10 2008 Version

E
Stormwater Management and Diffuse Flow Plan (required by DWQ)
1
Diffuse Flow Plan
la
Does the project include or is it adjacent to protected riparian buffers identified
❑ Yes ® No
within one of the NC Riparian Buffer Protection Rules?
1 b
If yes then is a diffuse flow plan included? If no explain why
❑ Yes ❑ No
Comments
2
Stormwater Management Plan
2a
What is the overall percent imperviousness of this project'?
<2%
2b
Does this project require a Stormwater Management Plan?
❑ Yes ® No
2c
If this project DOES NOT require a Stormwater Management Plan explain why During construction adequate sediment
and erosion control measures will be provided in compliance with the NC Mining Act
which incorporates the requirements
of the NC Sedimentation and Pollution Control Act Once the old pipes have been removed and the new pipes have
been installed and the work is complete and stabilized the sediment and erosion control measures will be removed The
quarry facility curemtly has a Stormwater Pollution Prevention Plan (SPPP) in place as required by the NPDES General
Stormwater Permit ( #NCG020000) that has been issued by the Division of Water Quality for this facility
2d
If this project DOES require a Stormwater Management Plan then provide a brief narrative description of the plan
❑ Certified Local Government
2e
Who will be responsible for the review of the Stormwater Management Plan?
❑ DWQ Stormwater Program
❑ DWQ 401 Unit
3
Certified Local Government Stormwater Review
3a
In which local government s jurisdiction is this project?
❑ Phase II
3b
Which of the following locally implemented stormwater management programs
❑ NSW
❑ USMP
apply (check all that apply)
❑ Water Supply Watershed
❑ Other
3c Has the approved Stormwater Management Plan with proof of approval been
❑ Yes ❑ No
attached?
4
DWQ Stormwater Program Review
❑ Coastal counties
❑ HQW
4a
Which of the following state implemented stormwater management programs apply
❑ ORW
(check all that apply)
❑ Session Law 2006 246
❑ Other
4b
Has the approved Stormwater Management Plan with proof of approval been
attached9
❑ Yes ❑ No
5
DWQ 401 Unit Stormwater Review
5a
Does the Stormwater Management Plan meet the appropriate requirements
❑ Yes ❑ No
5b Have all of the 401 Unit submittal requirements been met?
❑ Yes ❑ No
Page 10 of 13
PCN Form — Version 1 3 December 10 2008 Version

F
Supplementary Information
1
Environmental Documentation (DWQ Requirement)
la
Does the project involve an expenditure of public (federal /state/local) funds or the
❑ Yes ® No
use of public (federal /state) land?
lb
If you answered yes to the above does the project require preparation of an
environmental document pursuant to the requirements of the National or State
❑ Yes ❑ No
(North Carolina) Environmental Policy Act (NEPA/SEPA)?
1c
If you answered yes to the above has the document review been finalized by the
State Clearing House? (If so attach a copy of the NEPA or SEPA final approval
❑ Yes ❑ No
letter)
Comments
2
Violations (DWQ Requirement)
2a
Is the site in violation of DWQ Wetland Rules (15A NCAC 2H 0500) Isolated
Wetland Rules (15A NCAC 2H 1300) DWQ Surface Water or Wetland Standards
❑ Yes ® No
or Riparian Buffer Rules (15A NCAC 2B 0200)?
2b
Is this an after the -fact permit application?
❑ Yes ® No
2c
if you answered yes to one or both of the above questions provide an explanation of the violation(s)
3
Cumulative Impacts (DWQ Requirement)
3a
Will this project (based on past and reasonably anticipated future impacts) result in
❑ Yes ® No
additional development which could impact nearby downstream water quality?
3b
If you answered yes to the above submit a qualitative or quantitative cumulative impact analysis in accordance with the
most recent DWQ policy If you answered no provide a short narrative description
4
Sewage Disposal (DWQ Requirement)
4a
Clearly detail the ultimate treatment methods and disposition (non discharge or discharge) of wastewater generated from
the proposed project or available capacity of the subject facility
Page I 1 of 13
PCN Form — Version 1 3 December 10 2008 Version

5 Endangered Species and Designated Critical Habitat (Corps Requirement)
5a Will this project occur in or near an area with federally protected species or
❑ Yes ® No
habitat?
5b Have you checked with the USFWS concerning Endangered Species Act
❑ Yes ® No
impacts?
E:1 Raleigh
5c If yes indicate the USFWS Field Office you have contacted
❑ Asheville
5d What data sources did you use to determine whether your site would impact Endangered Species or Designated Critical
Habitat?
While this PCN Notification is being reviewed a revision to the NC mining permit will be requested prior to the
replacement and construction of the proposed stream crossing During the mining permit modification process the NC
Division of Land Resources Land Quality Section routes the application through various agencies including the North
Carolina Wildlife Resources Commission for review prior to issuing the modified mining permit With this project being
minor in scope with respect to impacts related to streams no issues with the North Carolina Wildlife Resources
Commission are anticiapated nor have any issues been raised by the North Carolina Wildlife Resources Commission on
previous mining permit modifications that have been issued for this location
6 Essential Fish Habitat (Corps Requirement)
6a Will this project occur in or near an area designated as essential fish habitat?
❑ Yes ® No
6b What data sources did you use to determine whether your site would impact Essential Fish Habitat?
A review of the mapping site for essential fish habitat was conducted The link to the website is
http //ocean flondamanne org /efh— coralAms /viewer htm
7 Historic or Prehistoric Cultural Resources (Corps Requirement)
7a Will this project occur in or near an area that the state federal or tribal
governments have designated as having historic or cultural preservation
❑ Yes ® No
status (e g National Historic Trust designation or properties significant in
North Carolina history and archaeology)?
7b What data sources did you use to determine whether your site would impact historic or archeological resources?
No historical resource was shown on a search of the NC Historic Sites website (http / /www nchistoncsites orgo and the
NC Office of Archives and History website (http //www history ncdcr govo In addition the list of properties and districts in
North Carolina entered in the National Register of Historic Places was reviewed This list can be found at the following
website link http //www hpo ncdcr gov /nrlist htm Furthermore each time a mining permit modification request is
submitted through the NC Division of Land Resources Land Quality Section the application is routed through the NC
Division of Archives & History A mining permit modification will be submitted for this project and based on our research
we do not anticipate any historical or archeological issues or studies to be required prior to the approval of the mining
permit modification for this project
8 Flood Zone Designation (Corps Requirement)
8a Will this project occur in a FEMA designated 100 year floodplam?
❑ Yes ® No
8b If yes explain how project meets FEMA requirements
8c What source(s) did you use to make the floodplain determination?
Page 12 of 13
PCN Form — Version 1 3 December 10 2008 Version

R Paxton Badham
VP Land and Environmental 6tnk, 1,1� 31 12-
Applicant/Agents Signatu Date
Applicant/Agent s Printed Name (Agents signature is valid only if an authonzation let rfrom the applicant
is provided )
Page 13 of 13
PCN Form — Version 1 3 December 10 2008 Version

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• Attach this card to the back of the mailplece
or on the front If space permits
1 Article Addressed to
A. Signature
X ❑ Agent
❑ Addressee
B Received by (Printed Name) C Date of Delivery
D Is delivery address different from item 1? ❑ Yes
It YES enter delivery address below O No
Mr Steve Kichefski
United States COE Wilmington District
Asheville Regulatory Field Office
151 Patton Ave, Room 208 3 Service Type
Asheville NC 288015006 IO'Cerrfied Mail ❑ Express Mail
❑ Registered UrRetum Receipt for Merchandise
❑ Insured Mail ❑ C O D
4 Restricted Delivery? (Extra Fee) ❑ Yes
2 Article Number 7 010 1670 0000 5 7 9 2 214 6
(Transfer from service laben
PS Form 3811 February 2004 Domestic Return Receipt
102595-024A -1540
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1 Article Addressed to
NC Division of Water Quality
401/Wetlands Group — DWQ
2321 Crabtree Blvd Suite 250
Raleigh, NC 27604 2260
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B Received by (Pnnted Name) C Date of Delivery
D Is delivery address different from item 17 ❑ Yes
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❑ Registered 01"Retum Receipt for Merchandise
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4 Restricted Delivery? (Extra Fee) ❑ Yes
2 Article Number 7 010 1670 0000 5 7 9 2 2139
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