20070979 Ver 1_Certification of Completion_20110630

NCDWQ Protect No X70979' ✓cr Z County bt'arld lle
Applicant /!/apar ZDI V S
Protect Name
Proy.�enco RV ` T/PNo ie- 5 90,
Date of Issuance of 401 Water Quality Certification V(. 3a 11
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules and
any subsequent modifications the applicant is required to return this certificate to the 401 Transportation Permitting
Unit North Carolina Division of Water Quality 1650 Mail Service Center Raleigh NC 27699 1650 This form
may be returned to NCDWQ by the applicant the applicant s authorized agent or the project engineer It is not
necessary to send certificates from all of these
Appkcant s Certification
I T W, Awm a 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 fie_: Date I
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
Engineer s Certification
Partial Final
I as a duly registered Professional Engineer in the State of North
Carolina having been authorized to observe (periodically weekly full time) the construction of the project for the
Permttee 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 Registration No
Date
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DNN Q Project No Z0070979
Applicant /JZPDT 171 ✓ S
Michael F Easley Governor
William G Ross Jr Secretary
North Carolina Department of Envirorment and Natural Resources
County
7-/,J 'Fow-ko l
a,-a4, /, //e.
Alan W Klimek P E Director
Division of Water Quality
Project Name 69 /00Y kcf) OS`— I., re e J
Date of Issuance of 401 Water Quality Certification 40//,/0%
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules and
any subsequent modifications the applicant is required to return this certificate to the 401 Transportation Permitting
Unit North Carolina Division of Water Quality 1650 Mail Service Center Raleigh NC 27699 1600 This form
may be returned to DWQ by the applicant the applicant s authorized agent or the project engmeer It is not
necessary to send certificates from all of these
Applicant's Certification
I T W Sow+'�a✓1 . P E hereby state that to the best of my abilities due care and diligence
«1s 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 9�2�I11
Agent s Certification
I he eby 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
Engineer s Certification
Partial — Final
Date
I as a duly registered Professional Engineer in the State of North
Carolina having been authorized to observe (periodically weekly full time) the construction of the project for the
Permittc.e hereby state that to the best of my abilities due care and diligence was used in the obse vation of the
construction such that the construction was observed to be built within substantial compliance and intent of the 401
Nate Quality Certification and Buffer Rules the approved plam, and specifications and other supporting materials
Signature
Date
Registration No
IV
Nor`thCarohna
Tran o' 7 n Per- q Unit A' /lfl(' llm
2321 Cr St oo.il v rd Sur a 2-0 Ra �gh Nort) Carolina uo04
Phone X19 7,.3 17co / FAX [phone] ! Int met. htto l/h2o enr state nc us /ncwetla ^ds
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