WQ0004823_NOV-2019-LV-0833 GC_20191119

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First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 5158 9122 7688 42
United States
Postal Service
• Sender: Please print your name, address, and ZIP+0 in this box"
NCDEQ
Division of Water Resources
943 Washington Square Mall
Washington, NC 27889
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■ Complete items 1, 2, and 3. 11 A.
■ Print your name and address on the reverse X
so that we can return the card to you.
■ Attach this card to the back of the mailpiece, B.
or on the front if space permits. 1 5
13 Agent
Cl«•�,- ❑ Addre
by (Printed Name) C. Date of I
1. Article Addressed to:
D. Is delivery aacf44 9nt from Item 1 Yes/
If YES, enter delivea�below:
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Rolf Blizzard, Fr-sident Vice
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Pine island- Currizur_k LLC
19
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4400 Silas Creek Pkwy
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Ste 302fio8lity�e
Winston. Salem, NC 27104
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0 Priority Mail ExpressO
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Signature
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❑ Rea�er9d Mail Restricted
Certified
9590 9402 5158 9122 7688 42
° Collect Mai sd Da"ren'
for
o Merchandise
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
Insured Mail
❑ Signature ConflrmatlonT
❑ Signature Confirmation
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7 018 0360 0001 9842 8539
Insured Mail Restricted Delivery
Restricted Delivery
(over $500
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt