20220460 Ver 1_Certification of Completion_20220623

CERTIFICATE OF COMPLETION
NCDWR Project No.: 2672—U- C0
County: C0t�Ck�oO�
Applicant: A1N*W\sj l.(�L�S CQ-1 14. 4V1/00Qy c� CC!)1(f1�
Project Name: ? / [ wc11 QS)6 N, ( l ka_-I /1 \L
Date of Issuance of 401 Water Quality Certification: 11Il l 2-1-
Certificate
of Completion
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 return this certificate
to the 401 Wetland & Buffer Permitting Unit, North Carolina Division of Water Resources, 1617
Mail Service Center, Raleigh, NC, 27699-1617. 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.
Applicant's Certification
I, Kifil U [ CC--v\V`A
, hereby state that, to the best of my abilities, due care and
diligence was.0 ed 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 t e approved plans and specifications, and other supporting materials.
Signature. -1/4k--,U�A Date: Ll (i( /22
Agent's Certification
I, , 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:
Engineer's Certification
Partial Final
I, , 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 Registration No.
Date
JUN 2.:' 2022