20190177 Ver 1_CofC attachments_20220517

NORTH CA€ OLINA
ROY COOPER Environmemcd Quality
Gos, .'r rl (Ar
MICHAE.L S. REGAN ���
%'ecrerury NCDWR Project No.: ZO/9Q17 7_ --__- County:
LINDA CULPEPPER
rrin=rr+s 04rett4r Applicant:
Project Name: 6" V 829 - 469 3-6 orl SR/526(A 1041,sx11eAo
Date of Issuance of 401 Water Quality Cerlification:
Certificate of Completion
Upon completion ofall work approved within the 401 Water Quality Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certificate to the 401 transportation Permitting
Unit, North Carolina Division of Water Resources, 1617 Mail Service Center, Raleigh, NC.'_7699-1617. This form
may be returned to NCDWR by the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
ApiVicant's Certification
I, 3r401dn-1 _/- 76`4,-sC hereby state that, to the best of my abilities, due care and diligence
was used in the observation ofthe construction such that the construction was observed to be built within substantial
compliance and intent ofthe 401 Water Quality Certification and Buffer Rules, the approved plans and
specificationsials.
Signature: Date:
Ageitt'.s Certifi"cation
I, hereby state that, to the best ol'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 supportin" materials.
Signature:
Engitieer's Certification
Partial Final
as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to 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 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,
Signature — —
Date
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Registration No. —
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