250047_NOV-2023-PC-0435 GC_20230831

■ Complete items 1, 2, and 3. �� �O,
■ Print your name and address n e reve
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:
Sammy Lane
10705 Hwy 55 W
Dover, NC 28526
G
X
B:`R€'ceived bj (Printed Name) _ C.
Z'4
D. Is delivery address different from item 1'
If YES, enter delivery address below:
Restricted Delivery
9590 9402 7626 2122 6871 51 ❑ Certified Mall Restricted Delivery
❑ Collect on Delivery
Article Number (transfer from serviCe label) ❑ Collect on Delivery Restricted Delivery
1 Mall
7D22 1670 0000 9974 3353 I Mail Restricted Delivery
of Delivery
l/27
ILNo
❑ Priority Mail Express®
❑ Registered Mail'^^
❑ Registered Mail Restricted
Delivery
❑ Signature Confirmation*°
❑ Signature Confirmation
Restricted Delivery
PS Form
2020 PSN

1
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95911 9402 7626 2122 6871 51
United States
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box -
Division of Water Resources
943 Washington Square Mall
Washington, NC 27889
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