20120521 Ver 1_Certification of Completion_20140106

Action I[3 Number; SAW-2012-01259
Cq u nty: INa,�ye
P�rmittee: NC�O� 8-�3841; 6rid,�e 215 a�er Bea�erdarn Creek on Sft122i near Gc�fds6arp, Wayne
C�iuntv. NC.
Date Perrr�it Issued: D81D612012
Project IUlanager: Tam Stef#en�
Ldpon cDmp�etion caf the aetivity authc�ri�ed �y this permit anc� any mitigat�vn required by the permit,
sign Chis certification a�d r�turn it to the folkowing acfdress:
US ARMY CRPS f]F EilIGIN�EFZS
1NILMINGT�IU ❑15T{C�
Attn: Thornas 5teffens
Washingtt�n Regulatary Field [}ffice
PoSt Office Box 10i?�l
Washington, f�orth Carolina 27889
Please note t'�at your peraraitted activity is subject to a c�mpliance i�►spectian by a L1.5. Army Corp� of
Engineers representati�e. If you fail ta cornply with t#t�s permit you are suhjeet to permit suspension,
modificatian, ar revpcatiqn.
I herehy certify that the work aut�rorized �y the a�sa�e referen�ed �ermit has been eompleted in
aGCardan�e with the terms and canditions r�f the �aid perrnit, and reqa�ired mitigatiQn was c€�mpleted in
accardance with the permit conditi�ns.
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Signa�ure af Perrnittee �ate

�T�CDWC� Pruject No.: ?A� Z4 � County: Q�r
AppIicant: 1`f ��?L�
Praject Name: �r� f � . Zi� �r�_ �� ��,� 7°- � i I° r*1o. g-�{?`�f ,_
Aat� nf Lss�ssace vf 4+p1 Water (3�ality Certificatinn: .�i 'u.rs� r%��1��
Certificate nf Complefian
�Jpa� complstian af alI work app���aved vuithin t.�e 4QI Water C��uality Certificat�an ar app�icabla T3�'ez' Ru1es, and
any subsequen# modi�catinns, the apptican# is reqnired ta retum this certificaie to the 4(}1 Transpnrtation Pennitting
Unit, Nnrth Carolina. Di�iszan vf Water Quality, 165a N1��1 Serviee Centex, Ralei�h, NC, 27699�1GS0. �T"h►s farm
rnay be ret�arned ta 1�CI3�Q by the appliratat, the applicant's author�zed agent, or ttse praject engineer_ It is not
necessary t� send certi�icaies frcrm ail of�tese,
ApFiicant's Certifrcafiora
[, , hereby s�ate that, to the b�st of my abilities, due care and diligence
was used i� tEte ol�servai�on of the r,ans�-uctioa such that the cor�s�uctican was abservzd ta b� huiIt within su�stan�ia�
camplianc� and intent of the 401 '�1'a.ter Qualaty Ce�tification �d Bs�f�er Ruies, �he approved plans and
specificatians, and �t�er supportan� materials.
Si,�nature: Date:
1i��l11'S �'�1'f�CA'tllTlt
I, ,�ereby sfiate that, to the best of �y abilities, due care a�zd diligence
t�as used in #he abservation flf the coust�`uetivn sueh �at the eonseruction was abs�rve� to h� tauiit within su#astantial
c+ampliance and intent oftbe �Q1 �Nater iQuaiity Certi�.cation and 8�sffer Rules, tl�e appreved plans and
�ecifications, an�3 +�Ehe�r supparting rnat�ria�s.
Signat�re:
Date:
Extgine�r's �'ertifr�ntiQrr
Partial � �inal
�, ��1, . Ni�,�.�, as a duly registered Pmfessi�nal Eugineer in thc State of 3�1nr6h
�ar�+lina, ltavfng been authorixed ta ol�serve (periadicatly, weekEy,f�Lf�u�j the constructian ofthe project,itsr the
Perms##ee h�by state 3��.t, to the best of �ny abitities, due care and dili�ence was used in the t�bservation oi the
constrvction su�ch that #he cvnstru.ctian was abserved ta be built within suhstantsal cc�mpl sar�ce and intent of t3'ie �O 1
Water �QuaIity Certiiication tusd Sui�er Rules, the apprnWed plans and specificatians, arsd other suppvrtin� materials.
Signete�r� �� i�e�isixation Nu. C'�32 d�f,�
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