20070208 Ver 2_Certification of Completion_20090806

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NCDENFt
North Carolina Department of Environment and Nat Im U
Division of Water Quality
Beverly Eaves Perdue Coleen H. Sullins AU G
6 2009
Governor Director
DENR. WA,TER CRJAJV R BRf?I??
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DWQ Project No.: F-O ' 07.07.0$ vZ County:
Applicant: Wxytp, cowuIm PVi tie- St
Project Name: L ?IIGt' wmr. ?A1414 St e
Date of Issuance of 401 Water Quality Certification:
Dee Freeman
Secretary
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 to return this certificate to the
401/Wettands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. 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, , 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:
If this project was designed by a Certified Professional
I, STr-= _w,l A- hAl LJt-ER , as a duly registered Professional !!, (i.e.,
Engineer dscape Architect, Surveyor, etc.) in the State of North Carolina, having been authorized
too serve (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 within substantial compliance and intent of the 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other
supporting materials.
Signatu ?Rogi9o4on No. ZZL.ZS_
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401 Oversight/Express Review Permitting Unit "FNt t 1,1 f ?I%%%
1650 Mail Service Center, Ralegh, North Carolina 27699-1650
Location: 2321 Crabtree Blvd., Raleigh, North Carolina 27604
Phone: [phone] FAX: [phone]
Internet htip:llh2o.enr.state.nc.uslncwetlandsl
NorthCarolina
Naturally
An Equal Opportunity 1 Affirmative Action Employer