20100495 Ver 1_Certification of Completion_20120612

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coleen H Sullins
Governor Director
DWQ Project No U(U— O County
Applicant 04)1611 GrIOOL�/2�
Project Name 47CGgS,S IZ1040 _rMP40,? -!
Date of Issuance of 401 Water Quality Certification
ac) 9#r-- M7°
Dee Freeman
Secretary
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/Wetlands Unit North Carolina Division of Water Quality 1650 Mail Service Center Raleigh NC
27699 1650 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 D�j16#T 0JOOG121l-,Q , 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 approve 1 s a d spe if►c ons and other supporting materials
Signature �� Date I �L 4&I 76/ ?.---
Agent s Certification
I Gt1l j-C y uJgL k02, 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 pd ec►fications and other su porting material
Signature r Date
If this project was designed by a Certified Professional
I as a duly registered Professional (i e
Engineer Landscape Architect Surveyor etc ) in the State of North Carolina having been authorized
to observe (periodically weekly full time) the construction of the project for the Permitee 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 Certif► ►cation and Buffer Rules the approved plans and specifications and other
supporting materials
Signature
Date
401 Oversight/Express Review Permitting Unit
1650 Mail Service Center Raleigh North Carolina 27699 1650
Location 2321 Crabtree Blvd Raleigh North Carolina 27604
Phone [phone] FAX [phone]
Internet http tlh2o enr state nc uslncwetlandsl
An Equal Opportunity 1 Affirmative Acton Employer
Registration No
NorthCarolina
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