20031000 Ver 1_Certification of Completion_20040902

op wArF9 Mk~asl F. eas,~,,. t3owmor
Q w~llam Gl. Ross Jr., Sac~sbry
NoRh Carolina Depamnent of Er>,rironm~rn and Natured Rosour~es
> ~ ~ Aton w. Klimek. P.E.. Ob+setor
a Y Oivislor+ d water Qoaliry
OWQ Project No.:
l~3- loam
County:
W ~k~
Appgcanr. ~. ~- S Gow~~m~cja.I ~ ~`}~Ies
Project Name: La k~~neJ ~N bd ivisi or C.~ 1 ft~ry ~e-lN?ir lw~ prov~~Fs
-r-,
Date of issuance of 401 Water Quality Certfflcation: S~f- l 2 ~ 2003
cerbfl , e of conroaaon
Upon completion of ap work approved within the 401 Water Quality C®rtiflcation and Buffer Rules, and any
Q;~t;.seg;~~r;t modi~;lCgtiensy, the appliicant is regalra<; to retur= this G~'r$:;ICat@ to the 40iiv1ietiands unit, I~FOrtIt
Carolina Dlvtsion of Watsr Quality, 1621 Mail Service Center, Raleigh, NC. 27699-1621. This form may be
retum4d to OWQ by the applicant, the apptlcanYs authorized agent, or the project engineer. it is not
necessary to send certificates from ai! of these.
Appllearn'a CaU/lcai/ort
l• ~ K~~ ,hereby state that, to the best of my abilities, due care and
diligence was used in th. ob anon of the construction such that the construction was observed to be built
within substantial compUanco and infant of the 40i Water Quality Certification at~~i t~SR~,tQs the
approved sand bona, and other supporting materials. ()1 ~ROI/P
Si n~~=: Date: .~`~ d Y SEP Q-~p04
WATER QUALITY SECTION
AgsM's G'Ntl!lcadori
l~ , hereby state that, to the best of my abilities, due care and
diligence was used In the observation of the oonstrucaon such that the construction was observed to be built
within substantial oompliartce and intent of the 401 Water Quality Certification and Buffer Rues, the
approved plans and specifications, and ether supporting materials.
Signature:
Dete:
N this pr%ct rvs8 dea/grted by a CortMed Pro/asslonel
l~ ~O ~r'"~ ~~, as a duly registered Professional ~~ an ear (i.e.,
Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to
observe (periodically, )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 substanttal compliance and intent of the 401 Water Quality
Certificatio n /er Ruls, th/e approved plans and specifications, and other supporting materials.
Si nature ' 'i%'G' ~~r~~.-- ~ ~ c~ 'Z
g Registration No. ~~ ~ Date ~ I fl
`~
N, C. l]IVtston of Walar Ouraty, sot wetlands CertlNeatten unit,
1650 Mail 3sMcs Cable, Raislph, NC 27690-1x50 (AAaHInp Address)
2321 Crabas9 Blvd., Raleigh, NC 77E04.2280 (lrocstlon)
[phone] (phone). 919733.8883 (tax), (It2tpJlti2o.enrstate.nc.uslr~ewetlands