20040766 Ver 3_Certified Return Receipt_20080114

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JJ.~I l.i~aJ T~71•] t~~l~l111 `'~y~~u.o~-,~-~~._.~_ ___ _
^ 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:
Mr. James M. Gilbert
273-C B1>rie Pond Road
Clayton,NC 27520
UWQ# 04-0766-v3-Johnston
A.
X
~{~+_ C~ Agent
4 I"l e.1'I.c
B. R ved ~ (Printed Name) C. Date of Deliv
D. Is delivery dress different from item 1? ^ Yes
If YES, enter delivery address below: ^ No
3. Service Type
^ Certified Mail ^ Express Mail
^ Registered ^ Return Receipt for Merchandise
^ Insured Mail ^ C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. Article Number 70p7 256 ODD1 1381 0117
rrransfer from servlcE

UNITED STATES: ~OS~:~u' ERA ~'...,~""*^
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• Sender: Please print your name, address,'and ZIP+4 ifn this box • y
NC DE:NR Division of Water
Quality
401 Oversight/Express Unit
2321 Crabtree Boulevard Suite250
Raleigh,NC 27604