20100641 Ver 1_Certification of Completion_20100916

Page 5 of 5
NCDWQ Protect No ?-0 100641. County Be :6
Applicant T 01111.
Project Name {� 3Q_ 1t Rt'n1 . 4' c�� �"��t *�5 ©��er Tna.��'�k
Date of Issuance of 401 Water Quality Certification 5
,- i Zo I O
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules an
any subsequent modifications the applicant is required to return this certificate to the 401 Transportation Permitting
Unit North Carolina o NCDW Division b the applliicant, the applicant Service
agent, or the 27699 1650 This
notes
may be returned t Q Y
necessary to send certificates from all of these
Applicant's Certification
hereby state that to the best of my abilities due care and diligence
I
was used in the observation of the of the construction
Water Quality such
Certification and Buffer Rules the approved ed be plans and within substantial
compliance and intent
specifications and other supporting materials
Date
Signature
Agent s Certification
hereby state that to the best of my abilities due care and diligence
I
was used m the observa iothne of the construction
Quality such that the and BuffernRues observed the app owed be built plans an within substantial
compliance and intent of
specifications and other supporting materials
Date
Signature
Engineer's Certification
Partial _ Final
I S
nn . as a duly registered Professional Engineer m the State of North
Carolina having been authorized to observe (penodically weekly full time) the construction of the project,for e
Permittee hereby state that, to the best of my abilities due care and diligence was used in the observation of the
— construction such tioan and R le observed the app obed plans and specifications, compliance and pporting materials
Water Quality Certification
Registration No 07 3--lo(o
Signature
Date --J-�
CAF?
OF yl°
rC) 023466 ° 'U
Q �