20210317 Ver 1_Certificate of Completion_20210928

GOY COOPER
Governor
DIONNE DELLhGATTI ,
Secretary Fa'
S. DANIEL SMITH NORTH
Director Environn
WRProjectNo.: 40d /- 0317 County:
Applicant: Tim r9ty F /In &
Project Name:
Date of Issuance of 401 Water Quality
Certificate of Completion
Upon completion of all work approved within the 40
Rules, and any subsequent modifications, the applica
Buffer Permitting Unit, North Carolina Division of y
NC, 27699-1650. This form may be returned to DW
the project engineer. It is not necessary to send certi
Applicant's Certification
I, 7,1rh O_7/ti 1Fh7,b1 "!Ps.�,h
diligence was u d n the observationb fthe constn
within substantial compliance and intent of the 401
approved plans and specifications, a other suppc
Signature: D
Agent's Certification
I, hi
diligence was used in the observation of the constn
within substantial compliance and intent of the 401
approved plans and specifications, and other suppo.
Signature:
If this project was designed by a Certified Professil
I, , as
Engineer, Landscape Architect, Surveyor, etc.) in t
observe (periodically, weekly, full time) the constr
the best of my abilities, due care and diligence was
construction was observed to be built within substo
Certification and Buffer Rules, the approved plans
Signature:
Date
North Carollm
_
Asheville Regic
om'u:�14a�mnownr� /`�
828296AS00
RECENED
SEP 2 8 2021
RESOURCES
I PERMrmlva
Water Quality Certification or applicable Buffer
t is required to return this certificate to the 401 and
ner Resources, 1650 Mail Service Center, Raleigh,
by the applicant, the applicant's authorized agent, or
sates from all of these.
7y state that, to the best of my abilities, due care and
on such that the construction was observed to be built
ater Quality Certification and Buffer Rules, the
g materials.
state that, to the best of my abilities, due care and
i such that the construction was observed to be built
er Quality Certification and Buffer Rules, the
materials.
Iuly registered Professional (i.e.,
State of North Carolina, having been authorized to
ion of the project, for the Permitee hereby state that, to
ed in the observation of the construction such that the
al compliance and intent of the 401 Water Quality
d specifications, and other supporting materials.
Registration No.
nt of Environmental Quality I Division of Water Resources
1 2090 U.S. Highway 70 1 Swannanoa, North Carolina 28778