20150043 Ver 1_401_Certificate of Completion_125_20171017

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NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
NCDWR Project No.: _ yr/il 5��I.3 Connty: /kLA�(�NC�
Applicanh nLL o c� DI V'Z � M It . L11 Iy� ��1 I �1�5
Donald van der Vaart
Secrelary
Project Nemc: �2 ft I LS' ��f SYL Z 3 Z� ���ASS M ouN fAlnl 2L� 1
W3`� � 11 gP.7. YL. (02.
Datc of Issuflnce of 401 Watcr Qn�lity Ccrtificatio�c � 2.l1i lS
Ccrtificatc of Completion
Upon completion of all work approved within ihe 401 Waler Quality Certificntion or applicablc Buffer Rules, and
any subsequen[ modificatimis, �he applicant is required lo relurn this certificate �o Ihe 401 Transpoil��ion Permitling
Unit, North Carolin� Division of W�ter Resources, IG17 Mail Seivice Ccnter, Ralei�h, NC, 27699-IGI7. This form
may be returned �o NCDWR by the applicnnt, ihe �pplicant's authorized agent, m• the project engineer. It is not
necessnry to send certificates from all of ihese.
Applicnnl's Cenlflcn1lou
� ✓. /'rj _ �'vJ�'/ � S' , hereby st�te tliat, to thc best of my abilities, due cTre and diligence
was used in the observation of the emistruction such that the construction was observed to be built within substantial
complinncc �nd intent of Ihe 401 Water Quality Cerlifica[ion nnd Buffer Rules, the �pproved Nl�ns and
specifications, and other supporting ma[erials.
Signature:,-x� ���}��/�"`'��i,l DTtc: /o /.j —�/ %
�genl's erlifienila�
1, , hereby state �hat, to the best of my abilitics, duc care and diligence
was used in the observation of Ihe construction such that the cmisvuction was observcd to be built within subs�antial
compliauce and intent of lhe 40I Water QuTlity Certification nnd [3uffer Rides, the �pproved plans nnd
specifications, and other supporting m�terinis.
Signnture:
L•ngLreer's CeNifrcnllon
Partial Final
I, , ns a duly registercd Pirofessionnl Engincer in the State of Norlh
Carolina, having becn authorized to obscrve (periodically, weekly, full time) the conslruction of the project for Ihe
Pcrmitree hereby stn�e tli�t, ro the 6cst of my nbilities, due c�re and diligence �vns used in thc obscrvation of Ihe
consiruction such that the consreuction was observed to be built within substanti�l compli�nce and intent of the 401
Water Quality Certification nnd [3uffer Rules, the approved plans �nd specific�tions, and olher stipporting maleri�Is.
Signature
Date
Registrntion No.
1617 Mail Service Center, Raleigh, NoAh Carolina 27699�1617
Phone:[phone]nternet: www.ncdenr.gov
An Equal Opporlunity \ AlfrmaGve Aclion Employer