20040796 Ver 1_Certification of Completion_20090506

DWQ Project No.: OAF-O ? 96 County -Swa.; h
Applicant: Fe-a6yal M;,?kwn„ Adnivt;str,,tivh
Project Name: _ Ma-&RSM I817 Grea'+ Sm'k/" MOt-+A; s 1&"ehal Park Mew and Gap /?oad
Date of Issuance of 401 Water Quality Certification: 03 -,? b -,2 00 3 09-U B- Xoe
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 t,4 return this certificate to the
401JWetlands Unit, North Carolina Division of Water Quality, 169 Mail Service Center, Raleigh, NC,
27699-16*50 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:
Date:
Agent's Certification
I, Charles 'e, jy]Glto„ , 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 d s ifications, and other supporting materials.
Signature: Date:
Engineer's Certification
Partial Final
I, as a duly registered Professional Engineer in the State
of North C cling, having been authorized to observe (periodically, weekly, full 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 Registration No.
Date
ti?x?. Og
01 .