20071825 Ver 1_Certification of Completion_20110615

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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
DWQProjectNo.: 200~1~i3Z`j County: ~'LfSJ/1
Applicant: /V G 0 ~'T"
Project Name: (~ ~, 8 6 0.. S R l~ 22 aver G ~,e..t- C h, j3• (Z-K 4 0 6
Date of Issuance of 401 Water Quality Certification: ~ to ~~ o '7
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. 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 Ca~rtification
Signature:
Agent's Certification
1 S ~ ~ ~ o W M a'"~ ,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 appr v d la nd specifications, and other supRorti~tg materials.
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.
/f 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 Permitee 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
4D1 OversighVExpress Review Permitling Unit
1650 Mail Service Center, Raleigh, North Carolina 27699-1650
Location: 2321 Crabtree Blvd., Raleigh, Norlh Carolina 27604
Phone:[phone] FAX. [phone]
Internet: httpalh2o enrstate.nc.uslncwetlandsl
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An Equal Oppotlunily \ Affirmative Nc~ion Employer
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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves °erdue Coleen H. Sullins Dee Freeman
Governor Director Secretary
DWQ Project No.: Z o ~ 7 I n ~ 6 County: ~e (Z ~ ~1
Applicant: N c0u'r
Project Name: 'gr. SR m,vSK 1422 over SiurtiS CrtellL
Date of Issuance of 401 Water Quality Certification: t o l'~r I o
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rules, and any subsequent modifications, the applicant is required to return this certificate to the
401/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. 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• '^t ~ ~ a~^' ^^ °x~l ,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 appr~~ppv d 1 d specifications, and other supportinQg materials.
Signature: U_~~..!-~~._....--- Date: Z~telll
Agent's Certification
I, ,hereby state that, to the best of my abilities, due care
and diligence was used in [he observation of the construction such [hat 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.
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 constnlction of the project, for the Permitee hereby state
[hat, 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
401 OversighUExpress Review Permitting Unit
1650 Mail Service Center, Ralegh, Nonh Carolina 27699-1650
Location: 2321 Crabtree Blvd., Raleigh. Nodh Carolina 27604
Phone:[phone] FAX: [phone]
Interne[. httpam2o.enrstate.nc.uslncwetlandsl
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An'eaual Oooonunity \ Affirmative Action Employe: