20080380 Ver 1_Certification of Completion_20110701

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DR'Q Project \o.: 11ff0~~D _ i
Michael F. Easley, Gotremor
William G. Ross Jr., $epe~~,
Nonh Carolina Department of Environment and Natural Resources
Coleen H. Sullins, Director
Division of Water quality
Chants': ~ledi con
-lpplicant: 7 ~ t . , S~ o c - .V~ n -
Project~iame: Sa,,, ~„ /~ ,( SR /cacr
Date of Issuance oC401 Rater Quality Certification: ~~ q /~ 8
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Certificate of Completion
Upon completion oCall stork approved syithin the 401 Rater Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the 401 Transportation Permining
unit, North Carolina Division of «'ater Quality, 1610 Mail Service Center, Raleigh, KC, 27699-1650. This form
may be resumed to D~1'Q 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
uas used m the observation of the construction such that the construction seas obsen~ed to be built within substantial
compliance and intent of the 401 Cater Qualin~ Certitication and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Date:
Agent's Certification
' .hereby state that. to [he best of my abilities, due care and diheence
•s~as used m the observation of the construction such that the construction u~as observed to be buih within substantial
compliance and intent of the 401 Racer Quality Certitication and Buffer Rules, the appros•ed plan; and
specificatiuns, and other supporine materials.
~I^Ra Rl r2:
Date:
Engineer's Certitication
Partial _J~ Final
I, `t' ~ ~ c ~ f a; a dul,: reoisrered Professional Eneineer in the State of~orth
Carolina, ha ~mg be~„n au~-~~-ihori ed to obsen~e ~periodicall;:, «~ezkls', full timz) the constntction of thz project for the
Penrunee heteby state that, to the best of m}~ abilities, due cart and diligence seas used in the observation of the
construction such [ha[ the construction ss~as observed to be bull[ within substantial compliance and intent of the 401
R ater Quality Certitication and Buffer Rules, the appr6ved plans and sped Cica[ions, and other supportin_ materials.
Sisaansr ~'~ '- ~n~- ~~
~. Q Regisnation\b. 3 16S
Date T/~ 6 / I~ ~._--_
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,1(11. ' 1 2011
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7ransporta6on Permitting Unit
7650 Maa Service Censer, Raleigh, Nonn Carofna 276991550
2721 Crabuee Boulevard. Suite 250, Ralegn, North Carolroa 27604
Phone: 919-73J~t7861 FqX 919~i 77-6833 r Msemel: h4'o=/hoo <~r state tic us/tic etlands
qn Erlual Cpponuniry/gffirmalive q[tion Empbyer- 50°; RecyGeN10%POSi Consumer Paper