20120372 Ver 1_Certification of Completion_20120605

2012 10 31 FAX
Am- A
PCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
,verly Eaves Perdue Coleen H Sullins
ov rnor Director
DV IQ Project No
County 'I A (() 1h
ct Name
of Issuance of 401 Water Quality Cerhfication
Certificate of Completion
1@001
Dee Freeman
Secretary
U n completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any
sub equent modifications the applicant is required to return this certificate to the 401 /Wetlands Unit, North Carolina Division
of ater Quality 1650 Mail Service Center Raleigh, NC 27699 1650 This form may be returned to DWQ by the applicant,
the phcant s authortzed agent, or the project engineer It is not necessary to send certificates from all of these
in
in
the
in t
's Cerlffleadon
hereby state that to the best of my abilities due care and diligence was used
e observation of the construction such that the construction was observed to be built within substantial compliance and
it of the 401 Water Quality Certification and Buffer Rules the approved plans and specifications and other supporting
nals
Date
r J hereby state that, to the best of my abilities due care and diligence was used
e observation of the construction such that the construction was observed to be built within substantial comlphance and
it of the 401 Water Quality Certig, n and Buffer Rules the approved plans and specifications and other supporting
nals � �1 , 11
10
KV Y V�,Datc r
s project was d led by a C¢?Ipd Profession at
as a duly registered Professional _ (i a Engineer Landscape
itect, Surveyor etc ) in the State of North Carolina, having been authorized to observe (periodically weekly full time)
Mstruction of the project, for the Penmtee hereby state that to the best of my abilities due care and diligence was used
i observation of the construction such that the construction was observed to be built within substantial compliance and
t of the 401 Water Quality Certification and Buffer Rules the approved plans and specifications and other supporting
vials
tture Registration No
1650 Mad Serm Center Raleigh North Carolina 27699 -1650
La iron $12 N Salisbury St Floor 9 Raleigh North Carolina 27603 One
P 9191107-63011 FAX [phone] N hCarohna
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