20060853 Ver 1_Certification of Completion_20070713

Certification of Completion g~ "5 /
~'~~~'~~ p~o~ect No.: (~~ ~ $~~ County: ~ C ~~© ~
~~~~~--
=~~~::oant: /VIS. Iti ATtC I~EL>G-. C~stZ-Av'tT 1
-~e;,ttiame: IM1~1yQ t..~KE 5~%3D1~/t51o
_~_~ ~.= rs_ua_nce of Wetland Permit:
Certificate of Completion
r
'~ per. completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and a.: .
s~~secuent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North Carol:::.
~,~.:;inn of Water Quality, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form maybe returned to DWQ
_ C appcant, the applicant's authorized agent, or the project engineer. It is not necessary to send certificates from all ,
- ese
-lpplicant's Certification
K ~ T ~ E N~/a1... ~~ Ault i T F ,hereby state that, to the best of my abilities, due care and diligence ~~ :~
_~c ~~ the observation of the construction such that the construction was observed to be built within substant~::.
.. ~r_n!~ance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specificaror~.
a~.d other supporting materials.
:?-:an:re: ~~ ~-~i-,,rrT~ Date: '7 - ~.~ D
-igenr's Certification
1, hereby state that, to the best of my abilities, due care and diligence way
~~sed in the observation of the construction such that the construction was observed to be built within substantial
~ompltance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and specifications,
~~c other supporting materials.
~:-Tar'.~re
Date:
If This project was designed by a Certified Professional
`- as a duly registered Professional (i.e., Engineer,
_"escape .~rcllitect, Surveyor, etc.) in the State of North Carolina, ha~ring been authorized to observe (periodically,
.~ ee'~ly, full time) the construction of the project, for the Permittee hereby state that, to the best of my abilities, due care
~.e daigence was used in the observation of the construction such that -the construction was observed to be built within
s.:~s~antial compliance and intent of the 401 Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
`_ _.!rC
Registration No.
Q~~~o~~~
JUL 1 3 2007
Date
UEh1R -WATER QUALITY
1NETLAND3 AND STO',2~MIATER BRANCH