20030267 Ver 1_Certification of Completion_20031113

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(O /~~ , 2003
COMPLIANCE WITH WETLAND & BUFFER REGULATIONS
In accordance with Title 15 NCAC 2H .0500, the following DEED NOTIFICATION shall be recorded in the
C C7,t ~n County Registry prior to the conveyance of lots. Said Deed Notification shall apply to name of
subdivision, lot numbers in < ~.~c..~~ c .-~. County, North Carolina as shown on plans titled
L~~~lpuF LQnc{ihCy (insert subdivision name) prepared by ~~~~--- ~-~.--)- a~;~~--- ~y1 (insert name of
designer) dated date: Mr~v .Z 7 U 3
"A portion of this l~~t has been determined to meat i[,e requi:•cments for d~sigliation as a w;;tlard, strean: or r:ot:;c,ted
stream buffer. Any subsequent fill or alteration of this area shall conform to the requirements of the state rules adopted by
the State of North Carolina in force at the time of the proposed alteration. The intent of this provision is to prevent additional
wetland, stream or buffer filling or draining, so the property owner should not assume that a future application for filling or
draining would be approved. The property owner shall report the name of the subdivision in any application pertaining to
said rules. This covenant is intended to ensure continued compliance with all rules adopted by the State of North Carolina
and therefore the State of North Carolina may enforce benefits. This covenant is to run with the land and shall be binding on
all Parties and all persons claiming under them".
Owner's name: v~~Je" °`°`~ H"`~~`' r~t7cy5
Address: ~1 ~ ~ ~-~ 11`~~* ~~
City, State, Zip Code: _/U~J ~CrK ~ • ~- • ~S~ ~-'
Phone Number: (.~ S1-) ~-~`~ - .3 `'~~~
STfiI'E Or ~~ORTH CAROiJINA
~'t-~^^- COUNTY
WETLANIIS 6 gyp' ~~'t~t1,
I, / r1~V~(b ~r~ ~ 6Z~-'~5~~ , a Notary Public of the State of North Carolina, QJU~'VL--~ County,
hereby certify that owner personally appeared before me this day and executed by above certification.
Witness my hand and notorial seal, this b~ day of / ~1 U U , 2003
My commission expires: ~~~ a0 v~iUC)-]
Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E., Director
Division of Water Quality
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Si a re
OFFICIAL SEAL
Notary Public, North Carolina
County of Craven ~
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/ncwetlands

OF W grF9 Michael F. Easley, Governor
_ William G. Ross Jr., Secretary
~O~ QG North Carolina Department of Environment and Natural Resources
~~ Alan W. Klimek, P.E., Director
r7 ' .,~ ~''~ '~ Division of Water Quality
DWQ Project No.: (~ 3 °- Oz 6 7 County: ~ ~G~J ~~"
Applicant: ~ ~e.~e~ n..~~ f~r.;~-~ '(.~ ovS ~I/Fl'L.NNC~~ ! q~t;.~ :~~{~il3i~~
Project Name: ~~e ter: ~ c~.~~ N^-~ ~~ `~ ~S N~-~-~Zp03
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 4~d1/`'Vetlands Unit, North Carolina
Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621. This form may be returned to DWQ
by the. applicant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from
all of these.
Applicant's Certification
I, S~"~x~- a~.~ ~~:~- `~t7~C~S ,hereby state that, to the best of my abilities, due care and diligence
was used in the observation 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 specifications,
and other supporting materials.
Signature: Date: ~ . ,,tw ~ 3
~-. /`~ to /vr~'. u 3
Agent's Certification
I, ,hereby state that, to the best of my abilities, due care and diligence
was used in the observation 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 specifications,
and other supporting materials.
Signature: Date:
If this project was designed by a Certified Professional
I, as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe (periodically,
weekly, full time) the construction of the project, for the Permittee hereby state that, to the best of my abilities, due
care and diligence was used in the observation 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 specifications, and other supporting materials.
Signature:
Registration No.
Date

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/ncwetlands