20050943 Ver 1_COMPLETE FILE_20050531

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William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
Coleen H, Sullins, Deputy Director
Division of Water Quality
January 12, 2006
DWQ Project # 05-0943
Dare County
CERTIFIED MAIL: RETURN RECEIPT REQUESTED
Eliot Todd Gaskill
P.O. Box 388
New Bern, NC 28560
Subject Property: Eliot Todd Gaskill
Pamlico Sound [030155,30-22, SA, HQW]
WAIVER of 401 Water Quality Certification
Dear Mr. Gaskill:
Your application for a 401 Water Quality Certification was received in the Central Office on May 31, 2005.
According to our rules [15A NCAC 2H .0507 (A)], if final action is not taken within 60 days, the Certification
is waived unless DWQ has objected in writing to your application. Therefore, DWQ has waived the requirement
for an AFTER-THE-FACT 401 Water Quality Certification for the previous filling of 0.10 acres of wetland for
construction a duplex on the subject property located in Hatteras, NC on the Pamlico Sound as described in
your application dated May 9, 2005.
However if additional impact occurs or your development plans change, this waiver is no longer valid and a 401
Water Quality Certification will be required.
Please call Ms. Cyndi Karoly or Mr. Ian McMillan at 919-733-1786 if you have any questions regarding this
waiver.
Sincerely,
l \ u?:, o`er
cr'4Cyndi Karoly, Supervisor
401 Oversight/Express Review Permitting Unit
CBKlijm

N. C. Division of Water Quality, 401 Wetlands Certification Unit,
1650 Mail Service Center, Raleigh, NC 27699-1650 (Mailing Address)
2321 Crabtree Blvd., Raleigh, NC 27604-2260 (Location)
[phone] (phone), 919-733-6893 (fax), (http://h2o.enr.state.nc.us/newetlands
401 comments I hope
Subject: 401 comments I hope or yp
From: Tom Steffens <[e-mail]>
Date: Fri, 01 Jul 2005 06:57:34 -0400
To: ian <[e-mail]>
CC: Laurie Dennison <[e-mail]>
the following have been entered into BIMS...I '11 be in your office this morning to
see if they did and to say hello.
BIMS proj # County Applicant review d type reg rec
comment
20050918 Pasquotank Albert and Beatrice Wageli 30-Jun dcm maj
23-May
Issue nc
20050900 Washington Leonard Small, Phelps Farm Bulkheading 30-Jun dcm
maj 20-May
Issue nc
20051006 Beaufort Clearwater Marketing Inc 30-Jun dcm maj
1-Jun
Issue nc
>.
20050492 Beaufort Clearwater Ventures LLc 30-Jun nw18 25-May
Issue nc
20050962 Pamlico Windmill Pointe 30-JUn dcm maj 14-Jun
Issue w/cond that applicant not build rock roam, behind rip rap.
20050943 Dare Elliot Tod Gaskill 30-Jun,, nw18 14-Jun
Issue nc
toms
1 of 1 1 7/1/2005 7:23
MEMORANDUM
TO:' John Dorney Regional Contact:
Non-Discharge Branch WQ Supervisor:
Date:
SUBJECT: WETLAND STAFF REPORT AND RECOMMENDATIONS
Facility Name Eliot Tod Gaskill
Project Number 05 0943
Recvd From APP
Received Date 5131105
Project Type Wetland fill
Recvd By Region
County' Dare
County2
Region Washington
Certificates Stream
Permit Wetland Wetland Wetland Stream Class Acres Feet
Type; Type Impact Score Index Prim. ' Supp. Basin Req. Req
NW1 0TH K-7 O N F_ 30-22 SA HQW 30,155. 0.10 F
(- PV _0N (--F_ f F-C-F- f
Mitigation Wetland '
MitigationType Type Acres Feet
Is Wetland Rating Sheet Attached? 0 Y 0 N Did you request more info? 0 Y 0 N
Have Project Changes/Conditions Been Discussed With Applicant? 0 Y 0 N
Is Mitigation required? Q Y O N Recommendation: 0 Issue 0 Issue/Cond 0 Deny
Provided by Region: Latitude (ddmmss) Longitude (ddmmss)
Comments:
cc: Regional Office
Central Office Page Number 1

Triage Check List.
rim Date: CAS'
Proje&t Name: icfi ? r? : skr I
DWQ#: OS--004(3
County:
To: ? ARO- Kevin Barnett WaR.O Tom Steffens and Kyle Barn
? FRO Ken Averitte ? 'VtWiRO Noelle Lutheran
? MRO AlanJohnson ? WSRO Daryl Lamb
? RRO Mike Horan
From: ?rt?? Telephone : (919) 7 S.3-- X71
The file attached. is being forwarded,'o . our for your evaluation.
Please call if you nee&Asi 'stance.
? Stream length impacted
? Stream determination
? Wetland determination and distance to blue-line surface'.waters on USFW topo maps
? Minimization/avoidance issues
? Buffer Rules (Meuse, Tar-Pamlico, Catawba, Randleman)
? Pond fill
? Mitigation Ratios
? Ditching . .
? Are the stream and or wetland mitigation sites available and viable?
? Check drawings for accuracy
? Is the application consistent with pre-application meetings? - -
Cumulative impact concern
??
Comments: (I'm UK af 14J

PAYMENT
RECEIVED
Office Use Only: Form Version May 2002
No. 05 0 9 4 3
USACE Action ID No. DwQ
(If any particular item is not applicable to this project, please enter "Not Applicable" or "NIA".)
1. Processing
ALL U U ?- ?'
1. Check all of the approval(s) requested for this project:
® Section 404 Permit ? Riparian or Watershed Buffer Rules
? Section 10 Permit ? Isolated Wetland Permit from DWQ
® 401 Water Quality Certification
2. Nationwide, Regional or General Permit Number(s) Requested: 18
3. If this notification is solely a courtesy copy because written approval for the 401 Certification
is not required, check here: ?
4. If payment into the North Carolina Wetlands Restoration Program (NCWRP) is proposed for
mitigation of impacts (verify availability with NCWRP prior to submittal of PCN), complete
section VIII and check here:
5. If your project is located in any of North Carolina's twenty coastal counties (listed on page
4), and the project is within a North Carolina Division of Coastal Management Area of
Environmental Concern (see the top of page 2 for further de check here:
II. Applicant Information D
1. Owner/Applicant Information MAY 3 Y 2005
Name: Eliot Tod Gaskill DtNR - war a , T, ,,,•
Mailing Address: P.O. Box 388 ?'?TORMWATERBU, XH
Buxton NC 27920
Telephone Number: 252-305-2563 Fax Number: 252-995-5580
E-mail Address:
2. Agent/Consultant Information (A signed and dated copy of the Agent Authorization letter
must be attached if the Agent has signatory authority for the owner/applicant.)
Name: Charles Thomas Comening
Company Affiliation: Hatteras Environmentalists
Mailing Address: P.O. Box 831
Avon NC 27915
Telephone Number: 252-305-7754 Fax Number: 252-995-5580
E-mail Address: thomcom acharter net
Page 5 of 12
III. Project Information
Attach a vicinity map clearly showing the location of the property with respect to local
landmarks such as towns, rivers, and roads. Also provide a detailed site plan showing property
boundaries and development plans in relation to surrounding properties. Both the vicinity map
and site plan must include a scale and north arrow. The specific footprints of all buildings,
impervious surfaces, or other facilities must be included. If possible, the maps and plans should
include the appropriate USGS Topographic Quad Map and NRCS Soil Survey with the property
boundaries outlined. Plan drawings, or other maps may be included at the applicant's discretion,
so long as the property is clearly defined. For administrative and distribution purposes, the
USACE requires information to be submitted on sheets no larger than 11 by 17-inch format;
however, DWQ may accept paperwork of any size. DWQ prefers full-size construction
drawings rather than a sequential sheet version of the full-size plans. If full-size plans are
reduced to a small scale such that the final version is illegible, the applicant will be informed that
the project has been placed on hold until decipherable maps are provided.
1. Name of project: Eliot Tod Gaskill
2. T.I.P. Project Number or State Project Number (NCDOT Only):
3. Property Identification Number (Tax PIN): 06 9585 19 60 8230
4. Location
County: Dare Nearest Town: Hatteras
Subdivision name (include phase/lot number): Lot 1
Directions to site (include road numbers, landmarks, etc.): see location sketch on attached
Survey(upper left hand corner)
5. Site coordinates, if available (UTM or Lat/Long): n/a
(Note - If project is linear, such as a road or utility line, attach a sheet that separately lists the
coordinates for each crossing of a distinct waterbody.)
6. Property size (acres): .49 acres
7. Nearest body of water (stream/river/sound/ocean/lake): Pamlico Sound
8. River Basin: n/a
(Note - this must be one of North Carolina's seventeen designated major river basins. The
River Basin map is available at http://h2o.enr.state.nc.us/admin/maps/.)
9. Describe the existing conditions on the site and general land use in the vicinity of the project
at the time of this application: The site is located across from Hatteras Harbor marina
behind the coffee shop. Most of the usage here is commercial; however the land not directly
adiacent to HWY 12 is generally residential housing.
Page 6 of 12
10. Describe the overall project in detail, including the type of equipment to'be used: The Gaskill
project will consist of constructing a duplex. The fill for the project has already been placed
in the wetland and is currently under violation. The area marked "existing fill" is the area we
are applying for after the fact. The suitable fill material was brought to the site by dump truck
and spread by front end loader. When the fillip took place it was not clear as to whether the
borrow pit was jurisdictional. The total area filled is just shy of the .l acre for which we are
applying for at this time
11. Explain the purpose of the proposed work: The two reasons for the fill are first, to meet the
required setbacks for the installation of the septic area. The primary system must be 50' from
all wetlands, and the repair area must be 35'.
IV. Prior Project History
If jurisdictional determinations and/or permits have been requested and/or obtained for this
project (including all prior phases of the same subdivision) in the past, please explain. Include
the USACE Action ID Number, DWQ Project Number, application date, and date permits and
certifications were issued or withdrawn. Provide photocopies of previously issued permits,
certifications or other useful information. Describe previously approved wetland, stream and
buffer impacts, along with associated mitigation (where applicable). If this is a NCDOT project,
list and describe permits issued for prior segments of the same T.I.P. project, along with
construction schedules.
n/a
V. Future Project Plans
Are any future permit requests anticipated for this project? If so, describe the anticipated work,
and provide justification for the exclusion of this work from the current application.
no
VI. Proposed Impacts to Waters of the United States/Waters of the State
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
wetlands, open water, and stream channels associated with the project. The applicant must also
provide justification for these impacts in Section VII below. All proposed impacts, permanent
and temporary, must be listed herein, and must be clearly identifiable on an accompanying site
plan. All wetlands and waters, and all streams (intermittent and perennial) must be shown on a
delineation map, whether or not impacts are proposed to these systems. Wetland and stream
evaluation and delineation forms should be included as appropriate. Photographs may be
included at the applicant's discretion. If this proposed impact is strictly for wetland or stream
mitigation, list and describe the impact in Section VIII below. If additional space is needed for
listing or description, please attach a separate sheet.
Page 7 of 12
1. Provide a written description of the proposed impacts: The impact will be. I of an acre
Fill placed in the wetlands.
2. Individually list wetland impacts below:
Wetland Impact
Site Number
indicate on ma
Type of Impact* Area of
Impact
acres Located within
100-year Floodplain**
es/no Distance to
Nearest Stream
linear feet
Type of Wetland*
Parcel B (2 areas) fill 1/10 yes n/a riparian

* List each impact separately and identify temporary impacts. Impacts include, but are not limited to: mechanized clearing, grading, fill,
excavation, flooding, ditching/drainage, etc. For dams, separately list impacts due to both structure and flooding.
** 100-Year floodplains are identified through the Federal Emergency Management Agency's (FEMA) Flood Insurance Rate Maps
(FIRM), or FEMA-approved local floodplain maps. Maps are available through the FEMA Map Service Center at 1-800-358-9616, or
online at http://www.fema.Pov.
*** List a wetland type that best describes wetland to be impacted (e.g., freshwater/saltwater marsh, forested wetland, beaver pond,
Carolina Bay, bog, etc.) Indicate if wetland is isolated (determination of isolation to be made by USACE only).
List the total acreage (estimated) of all existing wetlands on the property: .49
Total area of wetland impact proposed: .1
3. Individually list all intermittent and perennial stream impacts below:
Stream Impact
Site Number
indicate on ma
Type of Impact* Length of
Impact
linear feet
Stream Name** Average Width
of Stream
Before Impact Perennial or
Intermittent?
leases ecify)

+ List each impact separately and identify temporary impacts. Impacts include, but are not limited to: culverts and associated rip-rap,
dams (separately list impacts due to both structure and flooding), relocation (include linear feet before and after, and net loss/gain),
stabilization activities (cement wall, rip-rap, crib wall, gabions, etc.), excavation, ditching/straightening, etc. If stream relocation is
proposed, plans and profiles showing the linear footprint for both the original and relocated streams must be included.
•• Stream names can be found on USGS topographic maps. If a stream has no name, list as UT (unnamed tributary) to the nearest
downstream named stream into which it flows. USGS maps are available through the USGS at 1-800-358-9616, or online at
wtiFw.uses.eov. Several internet sites also allow direct download and printing of USGS maps (e.g., www.topozone.com,
www.mapquest.com, etc.).
Cumulative impacts (linear distance in feet) to all streams on site: none
4. Individually list all open water impacts (including lakes, ponds, estuaries, sounds, Atlantic
Ocean and any other water of the U.S.) below:
Page 8of12
Open Water Impact
Site Number
indicate on ma
?a of Impact* Area of
Impact
acres Name
(if applicable) Watere) Type of Waterbody
(lake, pond, estuary, sound,
bay, ocean etc.

List each impact separately and identify temporary impacts. Impacts include, but are not limited to: fill, excavation, dredging,
flooding, drainage, bulkheads, etc.
5. Pond Creation
If construction of a pond is proposed, associated wetland and stream impacts should be
included above in the wetland and stream impact sections. Also, the proposed pond should
be described here and illustrated on any maps included with this application.
Pond to be created in (check all that apply): ? uplands ? stream ? wetlands
Describe the method of construction (e.g., dam/embankment, excavation, installation of
draw-down valve or spillway, etc.):
Proposed use or purpose of pond (e.g., livestock watering, irrigation, aesthetic, trout pond,
local stormwater requirement, etc.):
Size of watershed draining to pond: Expected pond surface area:
VII. Impact Justification (Avoidance and Minimization)
Specifically describe measures taken to avoid the proposed impacts. It may be useful to provide
information related to site constraints such as topography, building ordinances, accessibility, and
financial viability of the project. The applicant may attach drawings of alternative, lower-impact
site layouts, and explain why these design options were not feasible. Also discuss how impacts
were minimized once the desired site plan was developed. If applicable, discuss construction
techniques to be followed during construction to reduce impacts.
The proposed duplex and development were constructed based uuon the use of en>ineered neat
systems which minimize the space needed for the septic The engineered system therefore
requires less fill than conventional system which in the end means less impact to the site
VIII. Mitigation
DWQ - In accordance with 15A NCAC 2H .0500, mitigation may be required by the NC
Division of Water Quality for projects involving greater than or equal to one acre of impacts to
freshwater wetlands or greater than or equal to 150 linear feet of total impacts to perennial
streams.
USACE - In accordance with the Final Notice of Issuance and Modification of Nationwide
Permits, published in the Federal Register on March 9, 2000, mitigation will be required when
necessary to ensure that adverse effects to the aquatic environment are minimal. Factors
Page 9 of 12
including size and type of proposed impact and function and relative value of the impacted
aquatic resource will be considered in determining acceptability of appropriate and practicable
mitigation as proposed. Examples of mitigation that may be appropriate and practicable include,
but are not limited to: reducing the size of the project; establishing and maintaining wetland
and/or upland vegetated buffers to protect open waters such as streams; and replacing losses of
aquatic resource functions and values by creating, restoring, enhancing, or preserving similar
functions and values, preferable in the same watershed.
If mitigation is required for this project, a copy of the mitigation plan must be attached in order
for USACE or DWQ to consider the application complete for processing. Any application
lacking a required mitigation plan or NCWRP concurrence shall be placed on hold as
incomplete. An applicant may also choose to review the current guidelines for stream restoration
in DWQ's Draft Technical Guide for Stream Work in North Carolina, available at
http://h2o.enr.state.nc.us/ncwetlands/strmgide.html.
Provide a brief description of the proposed mitigation plan. The description should provide
as much information as possible, including, but not limited to: site location (attach directions
and/or map, if offsite), affected stream and river basin, type and amount (acreage/linear feet)
of mitigation proposed (restoration, enhancement, creation, or preservation), a plan view,
preservation mechanism (e.g., deed restrictions, conservation easement, etc.), and a
description of the current site conditions and proposed method of construction. Please attach
a separate sheet if more space is needed.
A payment will be made to the North Carolina Wetlands Restoration Program. Upon
confirmation if payment a receipt will be issued to the USACE.
2. Mitigation may also be made by payment into the North Carolina Wetlands Restoration
Program (NCWRP). Please note it is the applicant's responsibility to contact the NCWRP at
[phone] to determine availability and to request written approval of mitigation prior
to submittal of a PCN. For additional information regarding the application process for the
NCWRP, check the NCWRP website at htto://h2o.enr.state.nc.us/wrp/index.htm. If use of
the NCWRP is proposed, please check the appropriate box on page three and provide the
following information:
Amount of stream mitigation requested (linear feet):
Amount of buffer mitigation requested (square feet):
Amount of Riparian wetland mitigation requested (acres): .25
Amount of Non-riparian wetland mitigation requested (acres):
Amount of Coastal wetland mitigation requested (acres):
IX. Environmental Documentation (required by DWQ)
Does the project involve an expenditure of public (federal/state) funds or the use of public
(federal/state) land?
Yes ? No
Page 10 of 12
If yes, does the project require preparation of an environmental document pursuant to the
requirements of the National or North Carolina Environmental Policy Act (NEPA/SEPA)?
Note: If you are not sure whether a NEPA/SEPA document is required, call the SEPA
coordinator at [phone] to review current thresholds for environmental documentation.
Yes ? No
If yes, has the document review been finalized by the State Clearinghouse? If so, please attach a
copy of the NEPA or SEPA final approval letter.
Yes ? No
X. Proposed Impacts on Riparian and Watershed Buffers (required by DWQ)
It is the applicant's (or agent's) responsibility to determine, delineate and map all impacts to
required state and local buffers associated with the project. The applicant must also provide
justification for these impacts in Section VII above. All proposed impacts must be listed herein,
and must be clearly identifiable on the accompanying site plan. All buffers must be shown on a
map, whether or not impacts are proposed to the buffers. Correspondence from the DWQ
Regional Office may be included as appropriate. Photographs may also be included at the
applicant's discretion.
Will the project impact protected riparian buffers identified within 15A NCAC 2B .0233
(Meuse), 15A NCAC 2B .0259 (Tar-Pamlico), 15A NCAC 2B .0250 (Randleman Rules and
Water Supply Buffer Requirements), or other (please identify )?
Yes ? No ® If you answered "yes", provide the following information:
Identify the square feet and acreage of impact to each zone of the riparian buffers. If buffer
mitigation is required calculate the required amount of mitigation by applying the buffer
multipliers.
Zone" Impact
(square feet) Multiplier Required
Mitigation
1 3
2 1.5
Total
* Zone 1 extends out 30 feet perpendicular from near bank of channel; Zone 2 extends an
additional 20 feet from the edge of Zone 1.
If buffer mitigation is required, please discuss what type of mitigation is proposed (i.e., Donation
of Property, Conservation Easement, Riparian Buffer Restoration / Enhancement, Preservation or
Payment into the Riparian Buffer Restoration Fund). Please attach all appropriate information as
identified within 15A NCAC 2B .0242 or.0260.
Page 11 of 12
XI. Storm water (required by DWQ)
Describe impervious acreage (both existing and proposed) versus total acreage on the site.
Discuss stormwater controls proposed in order to protect surface waters and wetlands
downstream from the property.
Existing = 0%, Proposed =18%, map has been recorded with wetlands at county also if required
a retention basin with storm water calculation will be provided.
X11. Sewage Disposal (required by DWQ)
Clearly detail the ultimate treatment methods and disposition (non-discharge or discharge) of
wastewater generated from the proposed project, or available capacity of the subject facility.
The primary system will consist of an engineered peat system with septic tank and the same
system will be in place for the repair area. All of the systems and site plans have been approved
by Dare County.
XIII. Violations (required by DWQ)
Is this site in violation of DWQ Wetland Rules (15A NCAC 2H.0500) or any Buffer Rules?
Yes ® No ?
Is this an after-the-fact permit application?
Yes ® No ?
I
,XIV. Other Circumstances (Optional):
It is the applicant's responsibility to submit the application sufficiently in advance of desired
construction dates to allow processing time for these permits. However, an applicant may
choose to list constraints associated with construction or sequencing that may impose limits on
work schedules (e.g., draw-down schedules for lakes, dates associated with Endangered and
Threatened Species, accessibility problems, or other issues outside of the applicant's control).
icant/ envs MinVan Date
(Agent's signatur is valid onl . uthorization letter from the applicant is provided.)
Page 12 of 12
I
..p50943.
AGENT AUTHORIZATION FORM
FOR
CORPS OF ENGINEERS PERMIT APPLICATION
I, Tod G'.O.S?riC C the undersigned authorize Charles T. Corpening
to act as my agent to obtain a permit for work as described in the attached application &
plans.
PAYMENT
Sincerely, RECEIVED
Date Z
cos stem
a le
PROGRAM
April 18, 2005
Charles T. Corpening
P.O. Box 831
Avon, NC 27915
Project: Eliot Tod Gaskill County: Dare
The purpose of this letter is to notify you that the North Carolina Ecosystem Enhancement Program (NC EEP) is willing to
accept payment for impacts associated with the above referenced project. Please note that this decision does not assure that
the payment will be approved by the permit issuing agencies as mitigation for project impacts. It is the responsibility of the
applicant to contact these agencies to determine if payment to the NC EEP will be approved.
This acceptance is valid for six months from the date of this letter. If we have not received a copy of the issued 404
Permit/401 Certification within this time frame, this acceptance will expire. It is the applicant's responsibility to send
copies of the 404/401/LAMA permits to NC EEP. Once NC EEP receives a copy of the 404 Permit and/or the 401
Certification an invoice will be issued and payment must be made.
Based on the information supplied by you the impacts that will be mitigated are summarized in the following table.
River Basin Wetlands Stream Buffer Buffer
Cataloging (Acres) (Linear Feet) Zone 1 Zone 2
Unit (Sq. Ft.) (Sq. Ft.)
Riparian Non-Riparian Coastal Marsh Cold Cool Warm
Pasquotank 0.10 0 0 0 0 0 0 0
03020105
Upon receipt of payment, EEP will take responsibility for providing the compensatory mitigation for the permitted impacts
up to a 2:1 ratio. The magnitude of the compensatory mitigation will be as specified in the Section 404 Permit and/or 401
Water Quality Certification, and/or CAMA Permit. The mitigation will be performed in accordance with the Memorandum
of Understanding between the N. C. Department of Environment and Natural Resources and the U. S. Army Corps of
Engineers dated November 4, 1998.
If you have any questions or need additional information, please contact Carol Shaw at [phone].
Sincerely, pQ??
illiam D. Gilmore, PE
Director
cc: Cyndi Karoly, Wetlands/401 Unit
Doug Huggett, Division of Coastal Management
Tracey Wheeler, USACOE - Washington
Kyle Barnes, DWQ Regional Office - Washington
File
R-"-torte... F ... Prot& Our Stat&
j!•?A
NCDENR
North Carolina Ecosystem Enhancement Program, 1652 Mail Service Center, Raleigh, NC 27699-1652 / 91 9-71 5-0476 / www.nceep.net
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58057 NC.12 HIGHWAY
HATTERAS, NC 27943
Township County
HATTERAS DARE
Date File Number F.I.R.M. Zone
3673-WS 12/22/04 AE
Scale IFB/Po [Base Flood Elevation
111=60' 101/10
Recorded Reference
0795/772
Community/Panel/Suffix
375348 0855 E
NORTH CAROLINA
Pin Number
06 9585 19 60 8230
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LOCATION SKETCH. NOT TO SC
i Complete items 1, 2, and 3. Also complete
Item 4 if Restricted Delivery is desired.
i Print your name and address on the reverse
so that we can return the card to you.
i Attach this card to the back of the mailpiece,
or on the front if space permits.
. Article Addressed to:
Eliot Todd Gaskill
P.O. Box 388
New Bem NC 28560
DWQ# 05-0943-Dare
Article Number
(i"ransfer from service labeow -?
!Q Fn" `All Fohnjnm 9nnd
A. Signature
? Agent
B. ReceAd by (Prinfat*Name) C. Date of Deliver
D. Is delivery address different from item 1? ? Yes
If YES, enter delivery address below: ? No
3. Service Type r
dJ certified mail ? s c y,
A1? ! W
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? Registered A R oeipt for
? Insured Mail ? C.O. 0
4. Restricted Delivery? Pd a Fee) Yes
7005 1160 0000 9954 8560
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UNITED STATES POSTAL SERVICE
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USPS USPS
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• 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
C 131r 1 IIiIl?1311IIIIIIIItitillll 1111111111111111111111111111 !!]IIII