20210952 Ver 1_Certificate of Completion_20210713

CERTIFICATE OF COMPLETION
NCDWR Project No.: 2 I ' OQ J �— County: L�IIIcoI
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
x
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Certificate of Completion VJ 1_
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer
Rule, • and any subsequent modifications, the applicant is required to return'this certificate to the 401
Wetland & Buffer Permitting Unit, North Carolina Division of Water Resources, 1617 Mail Service Center,
Raleigh, NC, 27699-1617. This form may be returned to NCDWR 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, I��e�. cam. er lam 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 ap roved plans and specifications, and other supporting materials.
Signature: A 9._,�� �, y\ Date: �tAy�Q 2�� u
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:
Engineer's Certification
Partial Final
Date:
I, , as a duly registered Professional Engineer in the State
of North Carolina, having been authorized to observe (periodically, weekly, full time) the construction of
the projectfor the Permittee 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.
North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 11617 Mail Service Corder I Raleigh, North Carolina 27699-1617
�ro•TM+�^�_�+� �"� 919.707.9000