20060964 Ver 1_Certification of Completion_20071119

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Michael F. Easley, Governor
_.�. __.._-----•------..___....� ._,--------__ _..__-------- William G. Ross Jr., Secretary
North Carolina Departrnent of Environment and Natural Resources
Coleen Sullins, Director
Division of Water Quality
DWQ Project No.: 20060964 County: �l.�ecombe
Applicant: NC Department of Transportation
Project Name: Brid.ge 85 on US 258 TIP# B-4934
Date of Issuance of 401 Water Quality Certification: June 19, 2006
Certificate of Completion
Upon complerion of all work approved within the 401 Water Quality Certificarion or applicable Buffer Rules, and
any subsequent modificarions, the applicant is required to return this certificate to the 401 Transportarion Pemutting
Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be retumed to DWQ by the applicant,. the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from a1T of these. ` `� ` " -
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Apphcant's Ce �cation
I, �� , hereby state that, to the best of my abiliries, due care and diligence
was used in the observation o the construchon such that the construction was observed to be built within substantial
compliance and intent of the 401 Water Quality. Certificarion and Buffer Rules, the approved plans and
specificarions, and other supporting materials.
Signature: � Date: . �l / � ��
Agent's Certification
I� , hereby state that, to the best of my abilities, due care and diligence
was used in the observarion of the construction such that the construction was observed to be liuilt within substanrial
compliance and intent of the 401 Water Quality Certificarion and Buffer Rules, the approved plans and
'specifications, and other supporting materials.. .
Signature: Date:
Engineer's Certi£cation
Partial Final
I; , as a duly reg'istered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically; weekly, full rime) the conshucrion of the project,for the
Permittee hereby state that, to the best of my abiliries, due care and diligence was used in the observarion of the
construction such that the construction was observed to be built within substantial compliance and intent of the 401 :
Water Quality Certification and Buffer Rules, the approved plans and specificarions, and other supporting materials. �
Signature Registration No.
Date ,
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Transportation Pertnitting Unit ��
1650 Mail Service Center, Raleigh, NoRh Carolina 27699-1650 ,
2321 Crabtree Boulevard, Suite 250, Raleigh, North Carolina 27604 .
Phone: [phone] FAX [phone] Intemet htto:/lh2o.enr.state.nc.us/ncwetlands
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