WQCS00046_NOV-2022-DV-0013 GC_20220119

ENDER: COMPLETE THIS SECTION
■ Complete items 1, 2;•and'3.
■ Print your flame and :address on the reverse
so that we can.reti.Mfiecard to you.
■ Attach this card to the back of the maiipiece,
or on the front if space permits.
A.
•
COMPLETE THIS SECTION ON DELIVERY'
,r joirjh
igna
geEC nt
❑ Addressee
B. -ec= +eed
C.
Date of Delivers
I. Article Addressed to:
_CITY OF BELMONT
PO BOX 431
BEEMMONT NC 28012-0431
AI lV: ADRIAN MILLER
,vr/mm 1/19/22
Eiji!
50I2I6I44I4III 2 I I
s delivd =ss different from item 1?
If YES, enter delivery add
3. Service Type
❑ Adult Signature
Adult Signature Restricted Delivery
Certified Mae
rtified Mail Restricted Delivery
0 Collect on Delivery
?._Article Number (Transfer from service label) 0 Collect on Delivery Restricted Delivery
El Insured 7I0ail • , 0 9 0 Did oil 2 31 i �I i 9i5116 1 1 l ail Raskrioted pelilrery
)S Fnrmt38i16..luly 2015 PSN 7530602-000-9053
■
■.
Priori
11 Express®
stered MaiITM
❑ Registered Mail Restrict,
Delivery
Return Receipt for
erchandise
❑ S gnature Confirmations
❑ Signature Confirmation
I Restricted Delivery
Domestic Return Receipt

i
i
LISPS TRACKING #
11111
i
I I
9590 9402 5027 9063 9444 12
United tates
Postal rvice
First -Class Mail
Postaje & Fees Paid
LISPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box°
NCDEQ/WQROS
610 EAST CENTER AVE
SUITE 301
MOORESVILLE NC 28115
E'liil'Lill'Ijjtii'1tl;�ljitIt'IhUIfJjhIIfilljlji"IJPi1lJill„

• os a ervice
CERTIFIED MAIL° RECEIPT
Domestic TViail Only
For delivery information, visit our website at www.usps.coma.
FF
CE
L
SE
Certified Mail Fee
$
153
Extra Services & Fees (check box, add fee es appropriate)
❑ Return Receipt (hanicopy $
❑ Retum Receipt (electronic) $
❑ Cerdited Mail Restricted Delivery $
['Adult Signature Required $
❑ Adult Signature Restricted Delivery $
Postage
Total
$ '
Sent
due.
City,
CITY OF BELMONT
PO BOX 431
BELMONT NC 28012-0431
ATTN: ADRIAN MILLER
dwr/mm 1/19/22

:ernnea man service proviues
A receipt (this portion of the Certified Mall label).
A unique identifier for your mailpiece.
Electronic verification of delivery or attempted
delivery.
A record of delivery (including the recipients
signature) that is retained by the Postal Service'
for a specified period.
nportant Reminders:
You may purchase Certified Mall service with
Frst-Class Mail°, First -Class Package Service°,
or Priority Mail® service.
Certified Mail service is notavaiiabie for
International mail.
Insurance coverage is rtotavailable far purchase
with Certified Mail service. However, the purchase
of Certified Mail service does not change the ■
insurance coverage automatically included with
certain Priority Mail items.
For an additional fee, and with a proper
endorsement on the mailpiece, you may request
the following services;
- Return receipt service, which provides a record
of delivery (including the recipients signature).
You can request a hardcopy retum receipt or an
electronic version. For a hardcopy retum receipt,
complete PS Form 3811, Domestic Return
Receipt attach PS Form 3811 to your mailpiece;
[fie ioiiowing IoenenEs:
for an electronic return receipt, see a retail
associate for asslstance.To receive a duplicate
retum receipt fot no additional fee, present this.:
USPS®-postmarked Certified Mail receiptto the
retail associate.
- Restricted delivery service, which provides
delivery to the addressee specified by name, or
to the addressee's authorized agent
- Adult signature service, which requires the
signee to be at least 21 years of age (not
available at retail).
- Adult signature restricted delivery service, which
requires the signee to be at least 21 years of age
and provides delivery to the addressee specified
by name, or to the addressee's authorized agent
(not available at retail).
To ensure that your Certified Mali receipt is
accepted as legal proof of mailing, it should bear a
USPS postmark If you would like a postmark on
this Certified Mail receipt, please present your
Certified Mall item at a Post Office'" for
postmarking. If you don't need a postmark on this
Certified Mail receipt, detach the barcoded portion
of this label, affix it to the mailpiece, apply
appropriate postage, and deposit the mailpiece.
IMPORTANT: Save this receipt for your records.