20181395 Ver 1_Certification of Completion_20190114

ROY COOPER
t;ovemor
MBCHAEL S. HGAN
Socretary
NORTH CAROLINA
Environmental Quatlfty
LINDA CULPEPPER
dnf€rim Director
DWR Project No.: �U 0 1 J 1 County: M o
Applicant: `. \oimutl ('2iif -n
Project Name: ` i Nze [C,QL
Date of Issuance of 401 Water Quality Certification:0CI(I �& t/
Certificate of Completion
(9L9UWL �
,JAN 1 4'12019
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the DWR Central Office —
Wetlands and Buffers Permitting Unit at 1650 Mail Service Center, Raleigh, NC 27699-1650. Theis form may be
returned to DWR by the applicant, the appikant's authorized agent, sir 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,iih-e f'1U 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 specificatio s, and other supporting materials. /
Signature: /7 Otte: ++--
If this project was designed by a Certified Professional
I, . as a duly registered Professional (i.e., Engineer,
Landscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized to observe
(periodically, weekly, full time) the construction of the project, for the Permitee 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 wilthin substantial'compliance and'' intent of the 401 Water Quality Certification. and
Buffer Rules, the approved plans and specifications, and other supporting materiaK
Signature: Registration No.
Date
North Carolina Department of Environmental Quality Division of Water Resources
Fayetteville Regional Office i 225 Green Street, Suite 714 1 Fayettevihe. North Carolina 28301
910.433.3300