HomeMy WebLinkAbout20091216 Ver 1_Certification of Completion_20110428Certificate of Completion
DWQ Project No. _ I County: f5?L
Applicant: n I V QD-r
Project Name !??'?/' O 2v {?IPYIs (lY' ?l04IS
Date of Issuance of 401 Water Quality Certification: T)70r Prior }"?f
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, 1621 Mail Service Center, Raleigh,
NC, 27699-1621. 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, /- , 2VZ2 ?el ?- , hereby state that, to the best of my abilities, due care and
diligence was the observation of the construction such that the construction was observed to
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: 'ror Date:
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
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:
If this project was designed by a Certified Professional
Date:
I, , as a duly registered Professional
(i.e., Engineer, Landscape Architect, Surveyor, etc.) in the State of North Carolina, having beeftA?
authorized to observe (periodically, weekly, full time) the construction of the project, f h 2 `
Permittee hereby state that, to the best of my abilities, due care and diligence was used in .?0'?.,
observation of the construction such that the construction was observed to built within substan'fi??k?? ,
compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans grFa"
and specifications, and other supporting materials. `91cy
Signature: Registration No.: Date:
B-4117
SR 1820
Alexis High Shoals Road
Gaston County
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44"
Outlet
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