20191096 Ver 1_Certification of Completion_20200506

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11�NR - WATER RESOURCES
CERTIFICATE OF COMPLETION TRANSPORTATION PERMITTING UNIT
NCDWR Project County:
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Project Name: bi C-
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
Wedand kBuffer, Permitting Unit, North Carolina Division ofWafer Resources, -', 617 Maii Center
Raleigh, NC, 27699-1617. This form may be returned to NCDWR by the applicant, the applicant's
authorized agent, or the project engineer. It is not necessary to send certificates from all of these.
hereby state that, to the best of my abilities, due care
and diligence was use 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.
- I 96h, - Signature*'' Date:
Agent's Certification
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l';d Z' 2a �'a hereby state that, to the best of my abilities, due care
andwas 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.
4
Signature: Date:
Engineer's Certification
1, , as a duly registered Professional Engineer in the State
of North Carolina, having been authorized to 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 Buffer Rules, the approved
plans and specifications, and other supporting materials.
Signature Registration No. Date