20191549 Ver 1_CofC attachments_20221021

DocuSign Envelope ID: 3F8E7lC7-3848-46AC-AED4-D782E418854D
ROY COOPER
GoTrmar
MICHAEL S. PECAN
Secretary
LINDA CULPEPPER
Dire, tor
NCDWR Project No.:
20191549
sTATE q„
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NORTH CA€ OLINA
Ert0ronmerreal Quality
County:
Brunswick
Applicant: North Carolina Department of Transportation
Project Name: Realignment of Wall St. at US 17 Business (Main St.) and Shallotte Ave.
Date of Issuance of 401 Water Quality Certification: January 7, 2020
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 Transportation 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, , 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:
Agent's Certification
Date:
I, Anneliese Westphal , 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: 4me4 .o U%x� Date: 10/21 /2022
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
Permttee 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
Registration No.
orlh Garullna Iaeparlmtrn of Einvir4inmenlal Quality I Dlvision of Water Rewurm
IEQ-
AW lmington Reglonal Office 1 127CardInal drive Extension I Wilmington.North Carol Ina 28405
� 910.7%.7215