20131068 Ver 1_Certification of Completion_20150515

8eve;ly Eaves Perdue
Governor
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North Carolina Department of Environment and Natural Resources
Divisicn of 4�1�ater Quality
Cc!een H. Suilins
Director
Dee Freeman
Secretary
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DWQ Project No.: ��6�-- County: �—r,�,k 1, n
Applicant: N (�
Project Name: g�. Zw�S (L ll�f? ov� �� �eek. �—�'7 �
Date of Issuance of 401 Water Quality Certification: ' ��I�I�Z
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
40�1/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 project engineer. It is not necessary to send certificates from all of these.
Applicant's Certification
I, �.Q � NoQ�� nS � Q RL' , 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 gj n n eci ti ns, and other supporting materials.
Signature: L,.. , ate: 2(� t3 L�-
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 desigried by a Certified Professional
I, , as a duly registered Profess.ional (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, far 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 Oversight�Express Review Femiitt:ng Uriit
1650 Mail Service Cen:er: Raleigh: North Carelina 27699-1050
Location: 2321 Crabtree Bivd., Raleigh, North Carolina 27"o�J4
Phone: 9 t 9-i 33-? 7861 FAX: 919 ?33-6893
Interne?: http:,?h2o.enrsta'e.nc.usincr,vetlands,`
Registration No.
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MAY��2015
DENR - WATER RESOURCES
An Equal i?; porunity ��.Aifinr:ati�:e ;c:ion Emplcyer 7RANSPORTATION PERMITTING UNIT
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NorthGarolina
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