20061023 Ver 1_Certification of Completion_20070606

Certification of Completion
DVWQ Project No.: ~~o - /!~ Z ,~ / ti~ ~) \
County: C~ ~ ~ r -' ~ ~/
Applicant: 2 ,~., ,~, , e
C~~ er
Project Name: 2 a ,`, ,~ r ~ ~" 1
Date of Issuance of Wetland Permit: °-
_ Q~
Certificate of ComAletion
Upon completion of all work approved within the 401 Water
subsequent modifications, the applicant is recui* Quality' Certification and Buffer Rules, and any
Division of Water Quality, 1650 Mail Service CentertRale'gh, NC 2 699-1650. This form ma~ a rem North Carolina
the applicant, the applicant's authorized agent, or the project engineer. It is not necess Y turned to D WQ by
these: cry to send certifica±es from al? o f
Applicant's Certification
~ hereby state. that, to the best of my abilities, due care and dill
used in the observation of~ the construction such that the construction was observed, to be built Bence was
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans. and eciufibcal~
and other supporting materials. sp lions,
Signature: .
Date:
Agent's Certification
used in the observation of the consl
compliance and iintenf of the 401 Wert,
and other suppo •~•
Signature: - ~ .
e ~ hereby state that, to the best ofmy abilities, due care and diligence:was
auction such that the construction was observed to be built within substantial
irt' Quality Certification and Buffer Rules, the approved plans and specifications,.
Date: _~ - p '7
If this p~-oject was designed by a Certified professional
I, -
L.andsca e ~ as a duly registered Prafcssional-
P . Architect, Surveyor, etc.) ~in .the Mate of North Caro • (i.e., Bngineer;
weekly, fu11 time) the construction of the project, for the Permittee he~,teby state that, to the best of observe (periodically,
cad diligence was used in the observation of the co my abilities, due care
substantial compliance and intent of the 401 Water Quality Certifica on and Bcutiffer was observed to be built within
specifications, and other.supPo~g materials..: ~ Rules; the approved plans and
Signature; - Registration No.
a ~ ~ ~ ~ V ~ -Date
. .JUN 6 2007
UEPIR -WATER QUALITY
4Y~T(.{Wpg A,'~D STQR~IWATER BRANCH

Phone/Fax: [phone] ~ Qua
Phone/Cell: 252-207-8877
License #: 52347, # 53241 Q COOS R D
Q
John M. Cooper
General Contractor
Residential & Commercial
Building Quality
PO Box 129 Poplar Branch, NC 27965