HomeMy WebLinkAbout20160727 Ver 1_Certification of Completion_20161220Water Rc�niu � i�,
eHvieormceirn� ����r,�.. .
NCDWR Projec[ No.: .a�1�22� 1
Applicanf: �� (�-r ���/�
PA'TMCCRORY
DONAI.D R. \�AN DGR VAART
i.'UIIIIIy: �71���(--�_
S. 1�Y 7_IMMGRMA�N
Projeat Name: ��LLCt��c � Z �� vi 5�- I �,�S���S r�. o_f 7� 7� IC, �
��
Date of Issu�nce of d01 Wa[er Quality Certification: �I_��j_I_� �r,
Certi�cate of Complelion
Upon completion of all wurk approved �vitliin the d01 Wa�er Quality Certifca[ion or applicable Buffer Rules, and
any subsequen[ modifications, [he �pplican� is rcqiiired ro return this certiticate [o the d01 Transportation Penni[tin,
Unit, Nurth Carolin� Division of Water Resources, 1617 Mnil Service Center, Ralei�h, NC, 27699-1617. This form
may be retw�ned to NCDWR by Ihe applicant, the applicmu's authorized aeent, or the projzct engineer. I[ is not
necessary to send certificates fi�om all of these,
�I pplicnnl's Cerlificnlrnn
I, :.� � j`��� '��� V� � _ , hereby s[ate that, to the best of my abilities, due care and dilieence
was uszd in Ihe observation of the consVuction such that the cunstruc[ion �vas observed to be built �vithin substantial
compliance and intent uf ihe 401 Water Quality Certific�tion and Duffer Rules, the approved plans and
specillcations, and oUier suppatine materials.
,Q � �/p� � �
Si�nanve: �t'. ' 1 • ` � i �'U ��� __ Date: _ CJ� �C— �
l
Agen!'s Cer/ifrailinn
I, , hereby state that, to the best of my abilities, due care and dili�ence
�vas used in the observa[ion of [he construction such tha� the construction was observed [o be built �vithin substantial
compliance and intent of tlie 401 Water Qualiry Certiflcation and Buf(er Rules. [he approved plans and
specifications, and other supporting ma(erials.
Signature:
Ei�giueer'.�' Certificnlio�i
P�rtial final
I, . as a duly registered Professional F.ngineer in ihe State of North
Carolina, having been authorized to observe (periodically. �veekly, full timc) the construction oFthe project for the
Permittee hereby state [hat, to lhe bes[ of my abilities, due care and dilieence was used in [he observatiun ot Ihe
construction sucli that the construction wns observed to be buil[ within substan[ial compliance and intent of d�e 401
Water Quality Certification and 8uffer Rules, the approved plans and specificntions, and other supporting materials.
Signanrce
Date
Registration No.
Slalc ul Nunh Camlina ��[nriromncnud Qualnp � W alcr Rcs'uurccs
16ll Mail Senice Cenler, Raleigh, NoM Carolina 276994fill