20040374 Ver 1_Certification of Completion_20081008

\O? RQ(r G William G Ross Jr Secretary
North Carolina Department of Environment and Natural Resources
7 Alan W Klimek P E Director
Division of Water Quality
O `C
DWQ Project No U x-03 ' 4 County 1A 14
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Applicant- NC O0 T-
ProlectName• 4-3349 -,??# to Crn?,f? Di7 (?S2[a,? c? ?o.?e ?uy
Date of Issuance of 401 Water Quality Certification 2005
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 tequircd to return this certificate to the 401/Wetlands Unit, North
Carolina Division of Water Quality, 1621 Mail Service Center, Raleigh, NC, 27699-1621 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, , 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
Agent's Certification
Date
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
Engineer's Certification
Date
Partial Final
I, S hLlwnl ce.1 , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (per,odxally, weekly, fall 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 -U.un I r?ivY Registration No 02.3-fCaL
Date Co /5 / ai?

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Unit 165 MaililatServ ce Center, Raleigh, North Carolina 27699 1650 c`7?'i'7 1,4417),
2321 Crabtree Boulevard Suite 250, Raleigh North Carolina 27604
Phone [phone] / FAX [phone] / Internet http //h2o enr state nc us/ncwetlands
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