20150467 Ver 1_Certification of Completion attachments_20200603 (2)

Action ID Number: SAW-2014-01705
Permittee: NCDOT -Division 3
County: Pender
Project Name: NCDOT / SR 1764 / Copperhead Lane / Division 3
Date Verification Issued: 05/18/2015
Project Manager: grad Shaver
Upon completion of the activity authorized by this permit and any mitigation required by
the permit, sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn:
-
FIELD -OFFICE -
Please note that your permitted activity is subject to a compliance inspection by a U. S.
Army Corps of Engineers representative. Failure to comply with any terms or conditions
of this authorization may result in the Corps suspending, modifying or revoking the
authorization and/or issuing a Class I administrative penalty, or initiating other
appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been
completed in accordance with the terms and condition of the said permit, and required
mitigation was completed in accordance with the permit conditions.
W� Date:2020.06.03
17:04:07-04'00'
Signature of Permittee
6/3/2020
Date