20110291 Ver 1_Certification of Completion_20120125

North Carolina Department of Environment and Natural Resou�42 6
Division of Water Quality W'frcA P61'R 11 Zc��Z
Beverly Eaves Perdue Coleen H Sullins ®�„NV S'I'T ? rlrDee Freeman
Governor Director Nrl�Rmh Seaetary
DWQ Project No cZ� l Qo1':I County usrk e,
Applicant �Q�p+ e:° lrZ iisfot— recrieti
Project Name tJ CS e- (S9 1 �/
Date of Issuance of 401 Water Quality Certification _q1-71,2011
i
Certificate of Completion
Upon completion of all work approved within the 401 WaterQual►ty 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 Mat Service Center Raleigh NC 27699 -1650 This form
may be returned to DWQ by the apphcank the applicant s authorized agent or the project engineer It is not
necessary to send certificates from all of these
Applicant's Certification
1 Ti,.,nf-Ay AnoLerson . �& 1= , 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 -- -Oeync 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 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
Permtttee 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
1617 Alec SWAN Center Raleigh, NoM CamMa 276Wt617
Locallon 512 N Sabbury St Raleigh. NoM Comma 27W4 One
Phone 919- t17-6301 FAX [phone] Customer Service' 1-877-623-8748 Caro a
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