20111052 Ver 1_Certification of Completion_20120802

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North Carolina Department of Environment and
Division of Water Quality
Beverly Eaves Perdue
Governor
DWQ Project No 20111052
Applicant
NCDOT
Natural Resources
Coleen H Sullins Dee Freeman
Director Secretary
County Lenoir
Project Name _Bridge #48 over Bear Creek
Date of Issuance of 401 Water Quality Certification _0l /l 1/2012
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 ther4U1/We`tlafds Unmet North CarnlinaIhvisiono
e--en_ _ _
ofd - Water'- Quality-165_0 Mail 9ervice_Cenier Raleigli; NG -27699 165 This form may be returned to DWQ by the applicant
the applicant s authorized age t the project engineer It is not necessary to send certificates from all of these
Applicant'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 approN ed plans and specifications and other supporting
materials
Signature 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
If this project was designed by a Cert fled Professional
I :3;14P D as a duly registered Professional F /At EVK, (i a 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 Certification and Buffer Rules the approved plans and specifications and other supporting
materials
Signature Registration No /V C, 07,0 7 02—
Date -7-1-7— /2—
O
1650 Mad Service Center Raleigh North Carolina 27699 -1650
Location 512 N Salisbury St Floor 9 Raleigh North Carolina 27603 1�9.yM� 2 <O r One
Phone 919$07 -63011 FAX [phone] USA4'0 "r�ll� !,? NorthCarolina
Internet www ncwaterquality org S1_1`Yr( f
An Equal Opportundy 1 Affirmative Acton Employer �✓414I Naturally
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