20100495 Ver 1_Certification of Completion_20120716

DVb Q Project No
Applicant
Project Name
Certificate of Completion
Date of Issuance of 401
County e e l
/ 16� �-
Water Quality Certification U
Upon completion of all work approved within the 401 Water Quality Certification and Burfe, Rules
and any subsequent modifications the applicant is required to return this certificate to the
401/Wetlands Unit north Carolina Division of �Nat�r Quaiity 1050 Mall Ser,,i(,e Center R ueigii
NC 27699 1650 This form may be returned to DWQ b) the applicant the applicant s authorized
agent or the project engineer It is not necessary to send certificates from all of these
ApplccaQQn��t'sppCertcficatron ,-Hu A S H ES]Dt�
I �""'L`'� hereby state that to the best of my abilities due care and
dill ce was used in the observation of the construction such that the construction was obser-, ed to
built within substantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules the anproNed plan-, and specifications a-id other supporting mate ials
Signature Date 1.9 3V i� •201
Agent's Certification
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
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
If this project was designed by a Certified Professional
I as a duly registered Professional
(i e Engineer Landscape Architect Surve) or etc ) in the State of North Carolina ha`
authorized to observe (periodically A eekly full time) the construction of the project f
Permittee hereby state that to the best of my abilities due care and diligence was used
observation of the construction such that the construction was obsen ed to built A ithm
compliance and intent of the 401 W ater Quality Certification and Buffer Rules the ap
and specifications and other supporing materials
Signature Registration No Date
9/
mtial
/¢lam 6 //
2012 C