20190113 Ver 2_Certification of Completion_20220325

Staff Review
.............................................................................................
DWR Project #: * 20190113
Reviewer List*
Version: *
Holley Snider:eads\hasnider
CERTIFICATION SUBMITTED ON 3/25/2022
2
Upon completion of all work approved within the 401 Water Quality Certification or applicable Buffer Rules, and any
subsequent modifications, the applicant is required to submit it to the DWR 401 & Buffer Permitting Branch. This form
may be returned to DWR by the applicant, the applicant's authorized agent, or the project engineer. It is not necessary to
send certificates from all of these.
Is this a Public Transportation Project?
Yes
No
USACE Permit# SAW-2019-00937
DWR Project #: 20190113 Version: 2
County: Brunswick
401 Water Quality Certification Issued Date:
3/25/2022
Applicant: Brunswick Regional Water and Sewer H2GO
Project Name: Leland Highway 17 Sewer Expansion II
Supplemental Attachments:
Click the upload button or drag and drop files here to attach document
SAW-2019-00937 - USACE Certification
866.03KB
Form - EXECUTED.pdf
PDF only
Who will be submitting the Certification of Completion?
Applicant
Agent
Certified Professional
If the project was designed by a Certified Professional:
I, as a duly registered Professional in the State of North Carolina, having been authorized to observe (periodically, weekly,
full time) the construction of the project, for the Permitee 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.
Type of Registered Professional: Engineer

Registration #: 047235
By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
o I agree that submission of the "Certificate of Completion" form is a "transaction" subject to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act")
o I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act");
a I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
a I intend to electronically sign and submit the "Certificate of Completion" form."
Printed Name: John Clark Maness
Signature