20180765 Ver 1_Certified Receipt_20190125

CERTIFIED MAIL,., RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
For delivery information visit our website at www.usDs.com

• ACertified �MailpPrOVideS: (—eAeu) ww -nr'ooee —j s,
■ A unique Identifier for your mallpiece
■ A record of delivery kept by the Postal Service for two years
Important Reminders:
■ Certified Mail may ONLY be combined with First -Class Mails or Priority Maio
■ Certified Mail is not available for any class of international mail.
■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. Fo
valuables, please consider Insured or Registered Mail.
■ For an additional fee, a Return Receipt may be requested to provide proof of
delivery. To obtain Return Receipt service, please complete and attach a Returr
Receipt (PS Form 38111 to the article and add applicable postage to cover the
fee. Endorse mailpiece Return Receipt Requested". To receive a fee waiver for
a duplicate return receipt, a USPS® postmark on your Certified Mail receipt it
required.
■ For an additional fee, delivery may be restricted to the addressee of
addressee's authorized agent. Advise the clerk or mark the mallpiece with the
endorsement "Restricted Delivery'
a If a postmark on the Certified Mail receipt Is desired, please present the arti•
cle at the post office for postmarking. If a postmark on the Certified Mai
receipt is not needed, detach and affix label with postage and mail.
MPORTANT: Save this receipt and present It when making an inquiry.
Internet access to delivery information Is not available on mail
rddressed to APOs and FPOs.

■ Cmplete g.
and & Also complete
Delivery Is desired.
■ Print your n d' address on the reverse
so that we kmtt,retum the card to°you.
■ Attach this card to the back of the mailpiece,`r
or on the front If space permits.
In 4'0
t. Article Number
3S Form 3911:
A. Sig Mbire
X
13 Agent
❑ Address
B. by (Printed Name)
C.
ate of
Ckro
vi
D. Is delivery address different from item 1?
13 Yes
If YES, enter delivery address below:
❑ No
3 Type
V�ed Mail ❑ Express Mail
❑ Registered ❑ Return Receipt for Mem.
❑ Insured Mail ❑ C.O.D.
I 4. Restricted Delivery? (Extra Fee) i NISs
7003 2260 0005 5380 9990
Recelot

UNITED STATeS� MERVICE First -Class Mail
Postage & Fees Paid
USIPSPermit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
DEO/DIVISION OF WATER RESOURCES
401 & BUFFER PERMITTING BRANCH
1617 MAIL SERVICE CENTER
RALEIGH, NC 27699-1617 �.
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