WQ0004823_NOV-2021-LV-0198 GC_20210412

9590 9402 6321 0296 8937 99
United States
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box•
NCDEQ
DIVISION OF WATER RESOURCES
WATER QUALITY OPERATIONS SECTION
943 WASHINGTON SQUARE MALL
WASHINGTON, NC 27889

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SENDER: COMPLETE THIS SECTION
• Complete items 1, 2, and 3.
• Print your name and address on the reverse
so that we can return the card to you. y�
■ Attach this card to the back of the mailpiece,%
or on the front if space permits.
COMPLETE THIS SECTION ON DELIVERY
A. Sign ure
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❑ Agent
❑ Addressee
B. Received by (Printed Name)
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s delivery address different from item 1? ❑ Yes
enter delivery address below: ❑ No
hey
i. Artirla Arlriraccari tn.
Rolf Blizzard, Manager 9e
Pine Island-Currituck LLC
4400 Silas Creek Pkwy Ste 39O,oe"p`
Winston Salem, NC 27104-3217o����
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9590 9402 6321 0296 8937 99
2. Article Number (Transfer from service label)
20 1810 0001 5981 0542
C. Date of Delivery
Service Type
61' Adult Signature
'O Adult Signature Restricted Delivery
,prCertified Mail®
❑ Certified Mail Restricted Delivery
❑ Collect on Delivery
0 Collect on Delivery Restricted Delivery
El Insured Mail
nsured Mat Restricted Delivery
over$500)
❑ Priority Mail Express®
❑ Registered Mari"
❑ Registered Mail Restricted
Delivery
0 Signature ConfirmationTM
❑ Signature Confirmation
Restricted Delivery
PS Form 3811, July 2020 PSN 7530-02-000-9053
Domestic Return Receipt