20181108 Ver 5_Green Card Return_20230622 (2)

■ Complete items 1, 2, and 3. L M�
■ Print your name and address on the
so that we can return the card to you.
■ Attach thts card to the back of the mallplece,
or on the front ff space permits.
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Tobin Tetterton
PO Box 125
Pantego, NC 27860
Ill�n � Illlbl II�II�I III al IIIII IN
9590 9402 7626 2122 6896 43
7022 1670 0000 9-1?4 3957
1 /Igo ❑ Agent
W ❑ Address
D. is dam address dffferard from Item 1? ❑ Yes
If YES, enter "Nery.address below: ❑ No
RECEIVED/NCDENR/DWR
JUN 2 6 2023
3. Service Type Warty My Ewe
oaduas4mre Water
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❑ adult
me P&SM
❑ certmed
❑ Cerffed Md
n
QCaed cn DOmy
❑
�ect an Ddlvay Re&Ued Delivery
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USPS TRACKING #
First -Class Mail
-- 'Postage & Fees Paid-
USPS
t Penntt No. G-10
9590 9402 7626 2122.6896 43
United States
Postal Service
• Sender. Please print your name, address, and ZIP+48 in this box•
�. NCDEQ
Division of Water Resources
943 Washington Square Mall
Washington, North Carolina 27889
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