20070302 Ver 2_Certification of Completion_20090818

RECEIVED
N_C DeDt. of ENR

Certificate of Completion

AUG 1 8 2009

DWQ Project No.: Of -o30Z County: ~R.SW
Applicant: _RIY\- Dt;V~L,OPjV'\6Ni) LLC /
Project Name: C A(li2..()~t-! CNr~L.L .t Z.

Winston-Salem
Regional Office

Date of Issuance of 401 Water Quality Certification:

mAY I, 2007
.

Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to ,the Winston-Salem Regional
Office, North Carolina Division of Water Quality, 585 Waughtown Street, Winston-Salem NC, 27107, 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 ofthe 401 Water Quality Certification and Buffer Rules, the
approved plans and specifications, and other supporting materials.

Signature:

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I, ---1\ ~ 'I2R\S 1S. Gl V'f+VN ,as a duly registered Professional E"N '" oS! '.. ~~~~fl'
Engineer, Landscape Architect, Surveyor, etc,) in the State of North Carolina, having been aut~~ , "\\,,,
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 Buft: les, t p roved plans and specifications, and other supporting materials.

Date:

If this project was designed by a Certified Professional

=<::.---Registration No,: 53(PD

Date: 8//2./2009
. I