20110212 Ver 1_Certification of Completion_20120718

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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins
Governor Director
D WQ Project No 11, - O rL f County R5 wt'h.t tti
Applicant
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PioJcct Name .__CURrJ,,JALLx<. 94t,;u Q ►/ WE+C
Date of Issuance of 401 Water Quahtv Certification 3 - 17 - t �
Cerhfic,itc of Completion
Dee Freeman
Secretary
Upon completion of all wort, approved ss ithmn the 401 Water Quaht) Certification or applicable Buffer Rules and any
subsequent modifications the 3pphcant is required to icturn this certif►rite to the 401 /Wetlands Unit North Carolina Division
of Water Quality 16-')0 Mail Sersice Center Raleibh NC 27699 1650 This form mati be returned to DWQ bN the applicant
the applicant s authorized agent or the project cngmeer It is not necessary to send certificates from all of these
Applicant v Ccrtrfrcation
I __ __ hereby state that to the best of my abilities due ca►e and dilibence sari used
in the observation of the construction such that the construction was observed to be built «ith►n substantial compliance and
intent of the 401 Heater Quality Cert►he Ition and Buffer Rules the approved plans and specifications end other supportinL
in nerials
Si-naturc
Agent s Certification
Date
I hereby state that to the best of my abihtie�, dtic care and dilifencc %%-is used
in the observation of the construction such that the construction uas observed to be built within substantial compli'mnc,e and
intent of the 401 Water Quality Certification and Buffer Rules the approved plans and spccifcations end other supporting
initerials
Sibnature _ Date
If llus project ii as rlevrr,nerl hi a Certified Pro(svtonal
I �-a6ky is a duly registered Professional Epiel aaaR Q a bngineer Landscape
Architect Surveyor etc ) in the State of North Caiohna havmL been authorized to observe ( eriodi al weekly full time)
the construction of the project for the Permitee hereby state that to the best of my abilities due care ind dilibence was used
in the observation of time construction such that the construction was observed to be built ssithin substantial comph ince and
intent of the 401 Water Quality Certification and Buffer Rules the approved plans and specifications and other supportmb
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17309
lilt '$��aeoaearea° °'v
1650 t ad gery e (, nter Ralei jh No Ili Garohna t7b99 16 ,)0 .1 a M2
Location 512 N b lisbury St Floor o RaIGgh �ortn Carolina 27603 One
Phone [phone]u01 FAX [phone] weeandF ��� . otJa,�l� y N rthCdrollna
Internet vxvv ncwaierquairty Ac StOrr�wateO' Branch Aatmrallly
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