20071575 Ver 1_Certified Return Receipt_20070920

Y • • • rtm~•~r~rm~x~is~ri~irewynoner
^ 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:
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Leonard Wilso~~ ~~ ~ `~
P.O. Rox 345 ` -', ~`L
Troutman,NC 2$~ 6~'' ,~`'
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DWC)# ~7-~ 575-~C~ '""r '',.,
A. ignatu
X ~ ~ n ^ Agent
i ^ Addressee
B. Receiveyl by (Printed Name) ~ C. Date of Delivery
D. Is delivery address different from item 1? ^ Yes
If YES, enter delivery address below: ^ No
3. Service Type
Cert'rfied Mail
Registered
^ Insured Mail
4. Restricted Delius
^ Express Mail
Retum Receipt for Merchandise
C.O.D.
(Extra Fee) ^ Yes
2. Article Number 707 1490 003 562 3089
(Transfer from service
Ps Form 3811, February 2004 Domestic Return Receipt io2sss-o2-M-tsao

UNITED STATES: n~ AI~,`~E4R ~
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• Sender: Please print your name, address, and ZIP+4 in this box •
NC DENR Division of Water Quality
4Ul Oversight/Express Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
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