20190462 Ver 1_Certificate of Completion_20210318

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
NORTH CAROLINA
EnWronmentar Quality
WRProjectNo.: /9-OZ162 County: IJLlfl9 6
Applicant: Wi N i a w� e lV/ U nt7
Project Name: L-akP -I 0214 11 ec Ir
Date of Issuance of 401 Water Quality Certification: _-I-cti
Certificate of Completion
RECEIVEDINCDENWR
MAR IS 2021
Watei Quality
permitting Section
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 the 401 and
Buffer Permitting Unit, North Carolina Division of Water Resources, 1650 Mail Service.Center, Raleigh,
NC, 27699-1650. This form may be returned to DWR by the applicant, the applicant's authorized agent, or
the project engineer. It is not necessary to send certificates from all of these.
Applic �/s Ce �ati
tam / t nn 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 specificationf , and other supporting materials.
Signature: X)��� �j`(/�t Date: 3 // S/.Z/
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 Certified Professional
1, as a duly registered Professional (i.e.,
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 Pemritee 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.
Date
North Carolina Department of Environmental Quality I Division of Water Resources
Asheville Re¢onalOftice{ 2090US.HI9hway70 I Svvannanoa.North Caro8na=18
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