20170260 Ver 1_Certified Return Receipt_20170508

■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and edd2ss on the reverse
so that we can retum the card to you.
■ Attach thls card to the back of the mailpiece,
or on the front ff space pertnits.
Article Atldressed to:
�.�
Mr. Mark Stafford. PE., Division Engineer
NCDOT. Division 12
1710 East Marion Street
Shelby, NC 28151
A�r� G �
ddressee
iedby LPn fed/v�Te) C. Date of Delivery
D. Is delivery address tliflerant fiom ttem i? � �es
It YES, anter delivery address below: ❑ No
3. Sarvice Type
❑ Cert'rfieG Mail
❑ Registered
❑ Inwied Mell
❑ Fxpress Mail
❑ Retum Receipt for Merchandise
❑ C.O.D.
4. Restricted Deliveyt (ExNa Fea) ❑ Yes
2. ArtICIeNumber 70�8 1300 000� 1124 2579
(iransler Irom seMcro /abel)
°S Form 3811 , February 2004 Domestic Retum Receipt +ozsss-oz-M-isae

� '� 1. J �.(�
UNITED STATES POS7AL SERSLICE
/+'�.�.�F7"� •I!
llTi'�
.
and ZIP+4 in
`r '� 2�1) �/'
ion f Water Resources
F` P�„ la ds Branch
n� nn Carpenter
1617 Mail Service Center
Raleigh NC 27699-1617
First-Class Mail
Postage 8 Fees Paid
USPS
Pertnil No. G-10
�iii�����i,i�i�iiiln�����lilili,ill�ivil,i�„Il�ilili�iui��ni

g- � ... , . . . ` ... '.
P�teqe S
ceninaa F�
Pmlmerk
Retum Recelpt Fae Here
(EnGarsemenlHeQulietl)
Restncted DeiWery Fee
(Entlorsemenl Rapuieed)
m�i a��ea a Faas L$ I �-.� n o 2 6D
�� � Mr. Mark Slafford, P.E.. Division Engineer
's5reei. NCDOT. Division 12 -'-'---
orPO 1710 East Marion Street
Ciry. S '-"...
Shelby. NC 25151

CertHled Meil Provides:
■ A mailing receipt
■ A unique klentiNer for your mellpiece
■ A recortl ot tlelivery kept Dy the Pos[el Service tor two years
Unporlent Rsm/nCen:
■ Certified Mail may ONLV De combiried with FlrsFClass Malb or Prlorily Mely
■ Certified Mail is not evelleble for eny claea ot IMematbnal mell.
■ NO INSURANCE COVERAOE IS PROVIDED wtth Certifletl Mell. Fo
valueblea, pleeae conakfer Inauretl a Regls[ered Mell.
■ For en fltltlPoonel fee, e Retum R fmey bB reqUestetl to provitla proof o1
delWery. To obtein ReWm ReCeipt 8e , pleeae complete end atlech e Returt
Receipt (PS Fortn 3811i ro Me aMcle and edd epplkable posteqe [o covar ME
fee. Entloroe mellplece ReWm Recelpt Requeeted'. To receiva e fee weiver fq
���� te retum recelpt, e USPS• postmerk on your Certlfled Mall receipt le
■ For an adtlitbnel fee, delivery may be reetricletl ro the etlOreesee o
eAtlreaeee's euthorizetl egent. Ativise the clerk or mark the mailpiece wNh 1M
endorsement 'ResMcfed Dellver.
■ If a poatmark on the Certifietl Mell receipt is tleslre4 please present the ertt
cle at t�e poat oflice for postmarking. If e postmerk on the Certified Mel
receipt is not needad, detech and aXix lebel with postege entl mall.
IMPOHTANT: Sare this receipt an0 present it when makinp an Inqulry.
P$ Fam 3800. Aupuet 2008 (qeverae) PSN ]53UO2-0Oo-904]