20181254 Ver 1_Certificate of Completion_20210415

RECEIVEDINCDEWWR
CERTIFICATE OF COMPLETION
NCDWR Project No.: 18-1254
Applicant: Carolina Garcia-Zaraqoza Villa
county: Cabarrus
Project Name: Chadbourne Ave./Chelwood Dr. Culvert Replacement
Date of Issuance of 401 Water Quality Certification: 29 October 2018
Certificate of Completion
APR 1.5 2021
Water duality
Permitting Section
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 Wetland & Buffer
Permitting Unit, North Carolina Division of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617.
This form may be returned to NCDWR 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
1, Carolina Garcia -Zaragoza Villa 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: C.arOliuq i7a2rr� �grA�o�rn Date:
Agent's Certification
4/12/2021
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.
Signature:
Engineer's Certification
Partial, Final
Date:
I, as a duly registered Professional Engineer in the State of
North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the
project for the Permittee 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.

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