20060157 Ver 1_Certification of Completion_20070321

Certification of Completion
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D WQ Project No.:_ _ _ County: ~ , {-e_1., e
Applicant: ~,,.~ R1 ~ ~ ~ n Cr" v ~~ ~ ~a. n
Project Name: ~o("~~j ~a~ ~',Ve!' .~n~-c,1C~e C~nr~ 1~ Cc,e55 ~oa~
Date of Issuance of (-~~r , ~ ~, ~(~~~
y01 Winer Q.,~,~,1•y Cz.r-~,f ~.~,~,~,,~
Certificate of Completion
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 401/Wetlands Unit, North
Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC 27699-1650. This form may be
returned to DV~JQ by the applicant, the applicant's authorized agent or ±he project engineer. It is not necessary to
send certificates from all of these.
Applicant's Certification
1, ~,CnAe.t V e.~nc', ~ ~ 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 terials.
Signature: ~ Date: ~~3~~-~
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:
If this project was de geed by a Certified Professional //~~
I ~ C'e , as a duly registered Professional (S~//~~"~- (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 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
observe built within substan ' 1 compliance and intent of the 401 Water Quality Certification and Buffer
Rules, e ap roved plans and sp i cations, and other supporting m/aterials/.
Signat ~ Date: - C ~Z~/ G
~~
~~,~ ~ 1 2007
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