20220191 Ver 2_Certification of Completion_20220613

Strickland, Bev
From: John Jakubowski <[e-mail]>
Sent: Monday, June 13, 2022 3:22 PM
To: Perez, Douglas J
Subject: [External] Certificate of completion #2022-0191V2
Attachments: Certificate of Completion Walkway to Dock.pdf
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Doug,
Please find the attached Certificate of Completion for my walkway project located at 356 Yacht Rd, Mooresville 28117
Please let me know if there is anything else I need to do.
Thank you for walking me through the process.
Best Regards,
John Jakubowski
[phone]
1

CERTIFICATE OF COMPLETION
NCDWR Project No.:
(l County: �t fZCOEM
Applicant:
Project Name: Y({-r +o cic�G�t
Date of Issuance of 401 Water Quality Certification: u • �y I c 0-1-G3a
Certificate of Completion
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
lV 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 approxed plans and specifications, and other supporting materials.
Signature: T6J"' "" T%x�--�- - Date: J U ^J
Agent's Certification
1, 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:
1, . 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. Date