20210994 Ver 1_Certificate of Completion_20210831

NCDWR Project No.: 21-0 el q 4
Applicant:
Project Name:
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)MPLETION Np� �\\
County: CA fa VDCA
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Date of Issuance of 401 Water Quality
Certificate of Completion
Upon completion of all work approved within the
Rules, and any subsequent modifications, the app
Wetland & Buffer Permitting Unit, North Carolina
Raleigh, NC, 27699-1617. This form may be retur
authorized agent, or the project engineer. It is no
Applicant's Certification
1,e1�� LehCla 11
and diligence was used in the observation of the i
to be built within substantial compliance and inte
Rules, the approved plans and specifications, and
Signature:
Agent's Certification
1, NIA 1-
and diligence was used in the observation of the i
to be built within substantial compliance and inte
Rules, the approved plans and specifications, and
Signature:
Engineer's Certification
Partial Final
of North Carolina, having been authorized to obs
the project forthe Permittee hereby state that, t
used in the observation of the construction such
substantial compliance and intent of the 401 Wa
plans and specifications, and other supporting m
Signature A/l ok
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Kvck, NC.
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01 Water Quality Certification or applicable Buffer
cant is required to ret rn this certificate to the 401
iivision of Water Resources, 1617 Mail Service Center,
ad to NCDWR by the applicant, the applicant's
necessary to send certificates from all of these.
state that, to the best of my abilities, due care
fiction such that the construction was observed
of the 401 Water Quality Certification and Buffer
supporting materials.
Date: gIJ�Izl
2by state that, to the best of my abilities, due care
istruction such that the construction was observed
of the 401 Water Quality Certification and Buffer
supporting materials.
Date: Al IA
as a duly registered Professional Engineer in the State
ve (periodically, weekly, full time) the construction of
the best of my abilities, due care and diligence was
at the construction was observed to be built within
r quality Certification and Buffer Rules, the approved
No. tj lk Date N