20110496 Ver 1_Certification of Completion_20131112

NCAWQ Project No.: � � � � � (�
A�plicant: 1�1C,[) dT -- piv�Si o
County: �(�h�2Y
Projecf Name: S� 1 2$ —cE tr,
Date of Issuance of 4q1 Watez• Quality Certification: � Ui Yt� !] , 2a j j ��
Certi�cate oi Co►x�pletio��
Upon co�npletion oiall wark appro�ed witltin i11e 401 Water Quality Ce�-tification ar applicabie B�iffer Rules, and
any subsequent modifications, tl�e a�plicant is rec�ui�•ed to return this certificate to the 4Q1 Transportatian Permittin�
Unit, North Carolina Division of WaCe�� Qualiry, 1650 Mai] Seivice Center, Ttaleigll, NC, 27b99-1650. This fo�•m
inay be returned to NCDWQ by the applicant, the app[icant's authorized agent, or the project engineer. It is not
necessary tn senc[ certificates froin all of tl�ese.
�,�pliccurt's Certifrcatiolr
I, , hereby state that, to the best of �ny aUilities, due eare and dili�ence
was used in the observatian of th� construction such that ihe construction was observed ta be buiit witliin substantial
co�nptiance and intent of the 401 Waker Quality Certificatian and Buffer Rules, the approved plans and
specifications, and other supporting materials.
5ignature: Date:
�Jg=efrt's Certrficrrtioir
I, ��es� es� �o�. � , hereUy state tl�at, to the best of �ny abi[ities, due care a�ld di[i�ence
was used in the obser�ation af t ie consta�uction such iiiat the constructian was obseE•ved to be built withi�l suE�stai�tial
co�nplia��ce and intent oftfae 441 Water Quality Certifcation and Buffer Rules, tlie approved plans and
specifiications, and othe�- sup�o�tinb materia[s.
Signature: ��i�,��l� (�(/ � Date: II r$�Zd 13 .�.
��rgi�teer's Certifrccrtiarr
Partial Fina]
1, , as a ciuly re�iste�•ed P�•ofessional Engineer in the State of NortE�
Carolina, having b�ei� authorized to oUserve (periodically, weekly, full ti�ne} tEle construction of the proj�ct,for the
Pei�nittee hereby state tEiat, to the best af my abilities, due care and diligence was used in the obs�rvation of the
construction sucl� tl�at tl�e coa�struction was observed to 6e liuilt within substantiai compliance and ii�t�nt of the 4�1
Water Qualiry Cez-ti�ication and Buffer Rules, the approved plans and specifications, and other suppartin; materials.
Si;nature Itegistrstion No.
DaCe