20130581 Ver 1_Certification of Completion_20150311

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C�WR �'�'c�JeCt i�lc�:
App�icant:
Pr�ject Narr�e:
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Cc��r��y: ��a�fa�t
Brid�e �#12�a �►rn SR 1725 aver J'c�rda�rt Cre�e�C
4fl1'�''����r C?��lity Certifw�c�ti�in Essue� D��e: J�s�y ��, �C7�.�
�Certi���at+e �af Comp��etiaan
Upon ccarrtpletir�r� c�f ��I w�rk �ppr�ved witP�i� tF�e 4C91 Water �u�luty C��tifi�atia�r a� app�icabl� Buffer
R�les, artd a�y subseq�aen� rnc�c�ifpcations, tfi� applic�r�t is �equ�re� ta return �his certifdcate tt� th�e C?LM1I'R
401 & E�uffer P'ermitting l�mit, 16�0 Mai� ��rvice Center, �al�igN�, NC, 27��9-1650. T�is fo�m rr��y b�
returr�ed to I�WR by the �ppNicant, tihe applicant`s a�tharized ager�t, or the p�oject eng,irreer. f� is r�cat
necess�ry fic� send cert�fica�tes ffr�m alV �f th�se..
�ppJi�trra�'s Cer�ifica�tian
�, , hereby st�te that, Co Ch�e best caf my a�i6i�i�s, due care and
dili�ence wa� us�d sn the ��aservatiar� af th� cor�st�°ucticrrn sucW� th�t tf�e can�tra�c4i�rr� was observed �� b�
kaa�%it witV�er� s�bstanti�l �c�mpli�c�ce ar�d �ntent a�the 4(7�. '1�'11a�er f�uality �ertificat4�r� �nd 6�f�er Rules, ttl�e
a,��arov�d pl�ns and specqficatican�, an�# �ather s�oppartim� m�ter6als.
Signature:
r�g'e"►1t',s �C�.'ll`LpNfiGfl�iL�fT
Dat�.
I, , hrere�ry stat� that, ta tW�e �est of r�y �biliti�s, du� care �r�d
diVig�nc� was used irn th� obs�rva�n�n af th� carastruc�6an such �hat t�e ��ans�ructian wa� ��s�erveetl t�r k�e
b�ai�t wi�thin su��tantial e��npl�ar�ce �r�d rnte�t ro�f the 4i11 1Nater Q�aGity C�rtif�catiar� and B�ffer N��le�, the
a�pproved �alans and specificatia��, �nd other supppr�ing rruateri'�Is.
Signature: �7���:
�f tiafs paro,ject �ar�r� d�si�ned by a Cert�fne�A P'rofession�l
r, c,�►aa�c ar�,, �a,.�J ,�' �..,J as a duly registered Pre�f�ss�onal ��G�.J�C:t�-{�i.e.�
Engi�ee�r, Landscape Architect, S�rvey�a�-, et�.) i� the St�te c�f �'c�rih Carc�lina, havur�g beer� auth�rUzed to
ab�err+e (periodi�alNy, w��kly, f�aRl tip�e} �k�e cmnstraacii�n �af tk�e per�ject, far the Perm�tee Fuereby stat� th�t,
ta th� b2st t�fi rr�y a�ilities, da�� c�re and dilo"��r�ce enras used irr the obs�^rvatir�n c�f tN�e ct�ns�ru�tiona ��uch
tf�at �he corastructic�n was observed to be baai�t within se�bst��ti�� cormpNfance and in�ent o� the �01 V'�ater
�ualpty Certificat�on and Buffer Ru�es, th� appraved plar�s ant� specifacatiar�s, a�d �ather s�u�portirrg
rrraterqaNs. �
Signature: ���- �... ,.,�, � C7ate: � J C �� �
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