20200311 Ver 1_Certifiate of Completion_20211012

NCDWR Project No.: o20 — 03 11
Applicant:
Project Name:
Date of Issuance of 401 Water Quality
Certificate of Completion
Upon completion of all work approved within the 4
Rules, and any subsequent modifications, the appli
Wetland & Buffer Permitting Unit, North Carolina I
Raleigh, NC, 27699-1617. This form may be return
authorized agent, or the project engineer. It is not
Applicant's Certification
I, ('ha�Les QDNNie Mil16s n
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
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 obse
the project for the Permittee hereby state that, to
used in the observation of the construction such tl
substantial compliance and intent of the 401 Wate
plans and specifications, and other supporting ma'
Signature
County: Q. o W a t`1 Co u O X
Pack Lak
Water Quality Certification or applicable Buffer
it is required to return this certificate to the 401
sion of Water Resources, 1617 Mail Service Center,
to NCDWR by the applicant, the applicant's
!cessary to send certificates from all of these.
?by 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: q-,;�o-aaa
state that, to the best of my abilities, due care
action such that the construction was observed
of the 401 Water Quality Certification and Buffer
her supporting materials. RECEIVED
Date:
21
DEOVATER RESOURCES
401 & BUFFER pEWIT7ING
s a duly registered Professional Engineer in the State
e (periodically, weekly, full time) the construction of
ie best of my abilities, due care and diligence was
t the construction was observed to be built within
Quality Certification and Buffer Rules, the approved
No. Date