20110044 Ver 1_Certified Return Receipt_20120820

■ 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.
1. Article Addressed to:
- ---- --_ _---- - ------ 1
' i
Ms. Trish Simon '
NCDOT- Division 12
� POBox47-- - - -- ---- --�
' Shelby, NC 28151 j l—(�U��L�
2. Article Number
(T'iansfer ir�m s
a
�
��/� ' `"� ❑ Addressee
B. Received by (P hted ame) C. Date of Delivery
..oJVj� '�h'�cDG� ��-a,o `'�v
D. Is delivery address different from Rem 11 ❑ Y�
If YES, enter delivery address below: ❑ No
a
Se ce Type
Certfied Mail
❑ Registered
❑ Insured Mail
�]�E�fgss Mail
etum Recefpt for Merchandise
C.O.D.
4. Restricted Delivery? (Extra Fee)
---
- — - �---- ---
7�09 225� 0000 8�87 4703
j PS Form 3811; Fe6ruary 2004 �� ( ;Domestic Return Receipt
I�ti �Vt tlisi4!i�t 1! ! 1 ! ; .
❑ Yes
102595-02-M•1540'

UNITED STATES POSTAL SERVICE
First-Class Mail
Postage 8 Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
' Mr. Brian Wrenn - - _ _
! Transportation Permitting Unit, NCDWQ
� 1650 Mail Service Center, Raleigh NC 27699-1650
�
`I�rIJI�„I�il��l�i��l�l�����ll�ll���iri�llr„i�itrl�i„l��,:f!

U.S. Postal ServiceT��� �
CERTIFIED MAILT��, RECEIPT
� (Domestic Mail Only� No Insurance Coverage Pravided)
For delivery information visit �ur website at www.usps.com�
� g ..
� Postage $
�O _
Certified Fee �j
� Po� ��/
� Return Receipt Fee
O (Endorsement Reqwred)
O /J �
Restricted Delivery Fee �.b
� (Endorsement Required)
u"!
fU TotaiPos• . __ _ .n _ . _ ,
f1J
�Q., sanrro Ms. Trish Simon �
Yp 'si."�r,aPr: NCDOT- DiVi510n 12 '
� or PD Box ,
ciry"'siera; PO Box 47 , r '
� Shelby, NC 28151 �'— �0`� � � .
- �u, �-- --.-

Certified Mail Provides:
■ A mailing receipt
a A unique identifier for your mailpiece .,
■ A record of delivery kept by the Postal Service for two years
Important Reminders:
s Certified Mail may ONLY be combined with First-Class Mail� or Priority Ma'ilp.
■ Certified Mail is not availabie for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to provide proof of�
delivery. To obtain Return Receipt service, please complete and attach a Return
Receipt (PS Form 3811) to the article and add applicable postage to cover the
fee. Endorse maiipiece."Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS� postmark on your Certified Maii receipt is
reqwred. • -
s For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent. Advise the clerk or mark the mailpiece with the
endorsement "Restricted Delivery". , r
■ If a postmark on the Certified Mail receipt is desired, please present the arti-.
cie at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed, detach and affix Iabei with postage and mail. ..
IMPORTANT: Save this receipt and present it when making an inquiry.=
PS Form 3800, August 2006 (Reverse) PSN 7530-02-000-9047