20020171 Ver 2_Certification of Completion_20070703

Certi~'ication of Com ~letion ~ B~hs ~
Dy~tQ Project No.:
Applicant:
Project Name:
~2-o~~1ve2
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County:
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Date of Issuance o€wetland Permit: ~ .
Certificate of Completion
Upon completion o€ aIt work approval within the 401 Water QnaIfty Certfficatlon and Buffer Roles, and an
aubsegpent modifications, the applicant.is required to return. this certificate to the 401/Wetlands Unit, North Carotin
Division of Fates Quality, 1650 Mail Service Cents, Raleaigh, NCB 27699-1654. This form may be re~:ned to DWQ b;
_. ~_-the applicant, the apphc~nt'a aathorizod_a or the prbjbct engineer. _ It is not necessary to 'send certificates from all o
these: ~ ~ ' . _
Appl-ic/ant's CertijRca~in. ~ ~ ~ ~ .
1V4~L- ~ D - hes+oby state that, to the best of my abilities, due care and diligence was
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used is the ohs " of~ the bonsttvction such that the construction was observed: m be built within substantial
compliance and i~t of the 401 Water Qaaliiy CertiScation and Buffrr Roles; the approved plans-and specifications,
and other supporti~ngf mateiia,ls. .
Signature:. , 6 ~ ~ ~ Date: ~ ~ ~ ~~`"" ~~~ ~ •
,
Agent's CertYfication
I, . ~ ~ ~ ~ ~ ., hereby state that, m the best of my abilities, ~dne care and diligence:was
used in the ~observatioa of the ~ construction such that the construction was pbserved to be built within substantial
compliance and inteof of the 401 ~ Wig Qua~- CertiScafion and 8u~er Roles; the approved plans 'and specifications,- .
Arid other supporting materials. ~ - -
.Signature; Date: .
If this project wars ateisigned. by a Certi, fTeal Professional _ .. .
I, = r ~ . ~ as a: duly rid Prof~s~ak (i.e.; ~Bugineer;
Landscape A.rcdi3tect; Surve3!or, etc.) ~in .the State of Na1th Caroli~, baying ~ ia~orized to observe (peaiodicallY,
weekly, full time) the construr,kion of the project; f~ the Permittee hrreby state that, to the best of my abilities, due~care ~.
acid diligence was used in the observation of the construction suc2r that the construction was observed to be butit within
substantial compliance and intent of the 401 Water Quality CertiHcat3on and.Buffer Rules,' the approved plans and
specifications, and othersupporting materials..: ~ ~- ~ _ , ~ .
Signature:
Registration No. ~ ~ Date, .
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