20041726 Ver 1_Certification of Completion_20070726

Dec 14 04 02:02p Carol Wright 252-249-1700 p.7
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Certification. of Completion la.-T ~
DWQ 1'rojcct No.: 6y' ~~0-1~ County: ~(~~~c.~
Applicant:
Project Name:
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Date cif Issuance of Isolated Wetland permit: ____~_
Certlfrcate of Completion
Upon completion of all work approved within the 40] Water Quality Certit"ication and Buffer Ytules, and any
`ubscqucnt modification., the applicant is rcyuircd to return this certificate to the 4Al/Wctlands jJnit, North Carolina
Division of Wa[cr Quality, 1650 Mail Scrvicc Ccntcr, Raleigh, NC, 27699--GSU_ This form may he returned to DWQ by
the applicant, the appl;cant's authorized agent, or the project engineer- It iS not necessary to send ccr[ificatcs from all of
thee.
A,pplicunt's Certification
i, ,hereby Mate that, to the best of my abilities, due care and diligence was
u~cd in the observation of the comtruction .uch thst the; construction was observed to Fx; built within substantial
eoanplianee and intent of the 40X Water Quality Certi~eatiorr aid Buffer Rules, the approved plans and specifications,
and other supporting rrutterials.
Signature:
,gent's Certification
llate:
1. ~~- ~ ~ ,hereby state that, to the bwt of my abilities, due care and dilibcnee was
used in the observation of the o struction such that the construction was observed to be built within substantial
compliance and intent of the 40] Water Quality Certification and Buffer Rule. the approved plans and specific;rtion~,
unei other supporti:~/ ~~a~t~urials. ~ ^~ (~
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b ~n arc: _~
If this project was designed by a Certified Professioizal
r. as a duly refiistered Professional (i.e., Entinccr.
Landscape Architect, Surveyor, etc.) in the State of North Carolina. having; been authorized Io observe; (periodically,
weekly, full time) the construction of the project, for the Permittee hereby state that. to the best of my abilities, due care
and diligence w:-s used in the observation of the construction such that the construction was observed to be built within
substantial compliance and intent of the; 40i Water Quality Certification and Buffer lEtules, the approved plans and
specifications, and other supporting materials.
Signature: Registration No, Date
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