20090802 Ver 1_Certification of Completion_20091208

Beverly Eaves Perdue
Governor
?LA
KNEW
North Carolina Department of Environment and
Division of Water Quality
Coleen H. Sullins
Director
Natural Resources
Dee Freeman
Secretary
DWQ Project No.:,o4&j!)q-- pgpa? County: tLa, .
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
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/Wetlands 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
al l of these.
Applicant's. Certification
1, , 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 plan p i
and other supporting materials. L -C ?3
Signature: Date: DEC - 2009
Igent's Certification DENR - WATER QUALITY
, hereby state that, to the best of my abilities, due NRA8NRA fl BRANCH
vas used in the observation of the construction such that the construction was observed to be built within substantial
:ompliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
:nd other supporting materials.
;ignature: Date:
rthis project was designed by a Certified Professional
in" r. r. , as a duly registered Professional ,n r- (i.e., Engineer,
.andsca Architect, Surveyor, etc.) in the State of North Carolina, having been aut orized to observe (periodically,
leekly, full time) the construction of the project, for the Permitee hereby state that, to the best of my abilities, due care
ad diligence was used in the observation of the construction such that the construction was observed to be built within
ibstantial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
)ecifications, and4ther supporting materials,
ignature / / e 4-0
-ate la
No. ;W (a-7
1650 Mail Service Center, Raleigh, North Carolina 27699.1650
Location: 2321 Crabtree Blvd., Suite 250, Raleigh, North Carolina 27604.2260 One
Phone: [phone] FAX: [phone] Customer Service: 1-877-623-6748 NorthCarolina
Internet: http:llh2o.enr.state.nc.uslncwetlands ;Vatmally
An Equal Opportunity 1 Affirmative Action Employer