20091068 Ver 1_Certification of Completion_20111107

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DW Q Pro�ect No
Appl►cant
Pro�ect 1Vame
Certificate of Completion
�� v Countv C�
A
Date of Issuance of 401 Water Quality Certificat�on � � �
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
4u 1/Wetlands Unrt North Carolina Division of W ater Quality 1650 Mail Service Center Raleigh
NC 27699 1650 This form may be retumed to DWQ by the applicant the applicant s authorized
agent or the pro�ect engineer It is not necessary to send certificates from all of these
Applccant's Certification
I =Saac. i�� �n So � 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 apgroved plans and s ecifications and other supporting materials
Signature .� 1
Agent's Certcficat�on
Date �o I3�'�s
1 hereby state that to the best of my abilrties due care and
diligence was used m the observation of the construction such that the construct on was observed to
bwlt wrthin substantial compliance and mtent of the 401 Water Qualrty Certifi � uffer
Rules the approved plans and specifications and other supporting materials �
�lo��
Signature Date N�V � D
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IJthis pro�ecl was descgned by a Cert fed Professzona[
w�„���� 0�1
� �
� as a da'y regis ered Profes�ional
(i e Engineer Landscape Archrtect Surveyor etc ) in the State of North Carolina ha�ing been
authorrzed to observe (periodically weekly full time) the construction of the pro�ect for the
Permittee hereby state that to the best of my abilities due care and dtligence 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 appro�ed plans
and specifications and other supporting materials
Signature Registrat�on No Date