20050655 Ver 1_Certification of Completion_20120206

Certificate of Completion L �� .` �� r
FEB 0 6 2012
DWQ Project No L/) -S D (D S county G k4 e S pFNg wATER vAjALTy
KRANDS AND STORMATER BRANCH
Applicant Ai G
Project Name 5K ` J R Y 1 V-' y KO)
Date of Issuance of 401 Water Quality Certification
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/Wedands 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 Certa, f Wfton
k
I , hereby state *t, to the best of my abilities, due care and
diligence was used in the observation of the construction such dig the construction was observed to be built
within substantial compliance and intent of the 401 Water Quahty Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials
Signature Date
Agent's CaAf Batton
I, ZoUa s e/ hereby state that, to the best of my abilities, due care and
diligence was used in the o servation 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
If this project was designed by a Cert&d Professtond
I, __ _, as a duly registered Professional (i e,
Engineer, Landscape Arclutect, Surveyor, etc ) in the State of North Carolina, having been authorized to
observe (periodically, weekly, full time) the construction of the project, for the Peimittee 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