20010034 Ver 3_Certified Return Receipt_20070806

• • • Ui41~A~~'37~I~yCy~i~/Ci1JL•]~~I~]q~19~:~'
^ 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.
Article Addressed to:
Sol Rose
Kings Grant Club
104 Gillespie Road
Fayetteville,NC 28301
DWQ# 01-0034-v3-Cumberland
A. Signature
^ Agent
/B. Received b (Pqrinte~dNaym~ej C. Da of D very
/r,CAG.~f~~I i",~ii ~~Q~D~~
D. Is delivery address different from item 1? ^ Yes
If YES, enter delivery address below: ^ No
3. S rvice Type
Certified Mail ^ Express Mail
Registered Return Receipt for Merchandise
^lnsured Mail C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. Article Number
(transfer from service -ai 7 0 0 5 18 2 0 ^ 2 2 2 2151 4 4 3 3
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STATES POSTAL SERVICE
i ii ii i
• 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 Suite25O
Raleigh,NC 27604
First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
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