20181206 Ver 1_Certification of Completion_20190930

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DWR Project No.: 1� I�r County.
Applicant: OR- [Tv
Project Name: -x- Q
Date of Issuance of 401 Water Quality Certification:
Certificate of Completion
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SEP 3 0 2019
Watt IN se tion
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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. This form may be
returned to DWR ylthe applicant, the applicant's authorized agent, or the project engineer. It is not necessary
to send certifica es from all 9f these.
Applicant's C rt' c L4— r ow
I, , hereby state that, to the best of my abilities, due care and
diligence wad ' the observation of the construction such that the construction was observed to be built
within substantial pliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved
plans and specifi a U&,.anather supporting materials.
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:
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 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
Registration No.
North Carolina Department of Environmental Quality Division of Water Resources
Fayetteville Regional office 225 Green Street, Suite 714 1 Fayetteville, North Carolina 28301
910.433.3300