20080960 Ver 1_Certification of Completion_20100812

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Certification of Completion p g - o? G C)
DWQ Project No.: pg - O'IZ,p County: -VIA KA
Applicant: p.?/,? o LFddo(
Project Name: 606 'AV ?
Date of Issuance of Wetland Permit: J o ,4T 9W6
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification, and any subsequent modifications,
the applicant is required to return this certificate to the 401 Oversight/Express Permitting 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 all of
these.
Applicant'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, the approved plans and specifications, and other
supporting materials.
Signature:
IR&EOW[g,
Date:
-??JG 1 2' 2010
DENR - WATER QUALf1Y
Agent's Certification WETLANDS AND STORUWATER BRANCH
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, the approved plans and specifications, and other
supporting materials.
Signature:
Date:
If this project was designed by a Certified Professional
I, /-,J-'46A4 , as a duly registered Professional AJV- (i.e., Engineer,
Landscape chitect, Surveyor, etc.) in the State of North Carolina, having been authorized to ob rve (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 a 1 tent of the 401 Water Quality Certification, the approved plans a4"p!!ff IOaY}?ns, and
other supporti s. `o? CARS , ?? ESSISignature: lateri uAA Registration No. Date 9 4a 10
SEAL
i s 17252 f
??'•.,FR D. CN?S•?'??

c?? Jones & Cnossen
ENGINEERING, PLLC
Civil Engineering I Construction Management I Land Planning
LETTER OF TRANSMITTAL
Date: Wednesday August 1 1, 2010
To: DIVI5ion of Water Qual
Company: 401 0ver51ght/ExprC55 Permitting Unit
1650 Mail Service Center
Raleigh, North Carolina 27G99-1 650
Job Name: Evans Road Extension
221 N. SALEM ST, SUITE 200
PO BOX 1062
APEX, NC 27502
Office: 919-387-1174
Fax: [phone]
www.jonescnossen.com
Job# 0586-C
5ublect: Certification of Completion
F Pick Up F Print(s) F
rV1 Mail Original(s) F
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r Check(s) F
Comments:
Peter D. Cn055en
r?
F Per Your Request
r for Review
17 Permit(s)
1? For Your Information
For Approval
for 51gnature
For Payment