20030076 Ver 1_Certification of Completion_20050215

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Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
~ DENR - V!`Ai Ert u~~~UTY Alan W. Klimek, P.E., Director
Q :~.x-'~ ~ 1hlk;'TUINDSAND STORMWAfERBRANCH Division of Water Quality
DWQ Project No.: _ 03-0076
County: Mecklenburg Coun
Applicant: Benham Builders (Jim Benham)
Project Name: Ki el don Court Lot #2 @ Pi per G1 en
Date of Issuance of 401 Water Quality Certification: January 31, 2003
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 401/Wetlands Unit, North Carolina
Divisiun 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
1 _ Jim Benham ,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. * Wetl ands fi 11 i s complete, house under construction. Wi 11
utilize level s reading devices and grass swales to filter stormwater after construction.
Signature: Date: 2 ~ ~ 4 ~p C
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Agent's Certification
1, _ ,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:
If tlzis~ project was designed by a Certified Professional
Date:
1, 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
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