20060853 Ver 1_Certification of Completion_20070712

pC~~C~a~IC~
.JUL 1 2 2007
uENFt • WATER QUALITY
iNETLAN0.S ANO STOR~IWATER BRANCH
DWQ Project No.: r~~
Applicant:
Project Name: Conk'"
Date of Issuance of Isolated
Permit:
of
eta.
Certificate of Completion

B~~ ~.
Upon completion of all work approved within the 401 Water Quality Certification and Buffer Rules, and any
subsequent modifications, the applicant is required to return this certificate to the 401/Wetlands Unit, North
Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC 27699-1650. This form maybe
returned to DWQ by the applicant, the applicant's authorized agent or the project engineer. It is not necessary to
send certificates from all of these.
Applican Certific ion
/" y abilities d e care and diIi epee was
I ~ ~ ~ ' / eby state that, to the best of my u g
used in the observation of the co struction such that th construction was observed to be built within substantial
compliance and intent of the 401 Water ~ty Cer • anon and Buffer Rules, the approved plans and
specifications, a of r supporting m to 'als.
Signature: Date: ~ O
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 Certif ed Professional
I , 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 Pesmittee 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:
letion
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