20050471 Ver 1_Certified Mail Receipt_20050727

^ Complete items 7 , 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:
Henry Revelle
Post Office Box 357
Murfreesboro, NC 27855
DWQ# OS-0471 -Hertford
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A. Sig ture
~,~/~~~ ^ Agent
X~/~~_~ ~ i/ ~ ^ Addressee
B. Received y (Printed Name) ~C. Date of Delivery
D. Is delivery address different from item 1? ^ Yes
If YES, enter delivery address below: ^ No
3. Service Type
~ertffied Mail ^ Express Mail
^ Registered etum Receipt for Merchandise
^ Insured Mail ~.D.D.
4. Restricted Deliver~/t (Extra Fee) ^ Yes
2. Article Number
(riansAer /-um service ~ahep 7 0 4 2 51 ~ 0 ~ ~ 6 3 3 51 7 0 6 8
PS Form 3811. February 2004 Domestic Retum Receipt 102595-02-M-1540

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UNITED STATES POSTAL SERVIlQ~` ~„ ~,1 First-Class Mail
Postage 8 Fees Paid
~. USRS ..
Permit No. G-10
...
• Sender: Please print your name, address, and ZIP+4. in this box •
NC DENR Division of Water Quality
401 Oversight/Express Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
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