20130776 Ver 1_Certification of Completion_20150520

Beverly Eaves Ferdue
Governcr
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North Carolina Department of Environment and fVatural Resources
Qivision of Water Quality
Coleen H. Sullins
Director
DWQ ProjectNo.: Z� 13 0?� 6 County: ���
Applicant: N cp��f'
ProjectName: �Y 2,d�� 2`� un S� (l�Z uv� /U�i.1h E(4+ �1.,,,�� l��`I %�5
Date of Issuance of 401 Water Quality Certification: �/� (� 3
Dee �reeman
Secretary
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
40l /Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or
the projecf engineer. It is not necessary to send certificates from all of these.
Applicant's Certification -
I, �, �. 1'��pk� n5, Q�. , 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 an an � pec� at' ns,�and other supporting materials.
Signature: • _._...Date: 2 �� t��� S'
Agent's Certification
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: Date: � �
If this project was designed by a Certified Professional
I, , as a duly registered Professional (i.e.,
Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized
to observe (periodically, weekly, full time) the construction of the project, for the Permitee 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 =
Date
401 OversighUEx�ress Review Remiitting Unit
1650 Mail Service Genier, Raleig�, North Gare,ina 27699-165�
Locatian: 2321 Crabtree Bfvd., Raleioh, North Carolina 27604
Phore: 919-?33- � 7R61 i=AX: 919-733-6893
Internet: http:�/h2o.enrstate.nc.us?navetlands,'
Registration No.
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f�AY 1 5� 2015
An Equal Opporiuni;y `, AHirmative Ac'tien Empieyer DENR • WRTER RESOURCES
7RANSPOR7ATION PERMITfING UNIT
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