20181195 Ver 2_404 permit completion form Greensboro St Ext_20200701

Action ID Number: SAW-2018-01709 County: Davidson
Permittee: North Carolina Department of Transportation, Division 9, Amy Euliss
Project Name: Bridge 100
Date Verification Issued: 11/14/2018
Project Manager: Bryan Roden -Reynolds
Upon completion of the activity authorized by this permit and any mitigation required by the permit,
sign this certification and return it to the following address:
US ARMY CORPS OF ENGINEERS
WILMINGTON DISTRICT
Attn: Bryan Roden -Reynolds
Charlotte Regulatory Office
U.S Army Corps of Engineers
8430 University Executive Park Drive, Suite 615
Charlotte, North Carolina 28262
or
[e-mail]
Please note that your permitted activity is subject to a compliance inspection by a U. S. Army Corps of
Engineers representative. Failure to comply with any terms or conditions of this authorization may
result in the Corps suspending, modifying or revoking the authorization and/or issuing a Class I
administrative penalty, or initiating other appropriate legal action.
I hereby certify that the work authorized by the above referenced permit has been completed in
accordance with the terms and condition of the said permit, and required mitigation was completed in
accordance with the permit conditions.
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Signa66re of Permittee
July 1, 2020
Date