20111074 Ver 1_Certification of Completion_20150515

Beveriy Eaves Ferdue
Gavernor
,�
North Carolina Department of Environment and Natural Resources
Division of VVater Quality
Coleen H. Sullins
Direc!or
DWQ Project No.: 20� (�U 7�( County: V a.�c Q-
Applicant: /Y c0 o i
Project Name: ��;�,a�c.. t�7 ou Q� �e� � �c% Cr Q ek �n S(Z l I Z a P> 9� Sl J 5�--
Date of Issuance.of 401 Water Quality Certification: t2��zlc�
Dee Freeman
Secretary
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/Wetlands Unit, North Carolina Division of Water Quality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be returned to DWQ by the applicant, the applicant's authorized agent, or
the project engineer. It is not necessary to send certificates from all of these.
ApplicanYs Certification
I, �,�• �fl�L>tr� , 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 withi ubstantial compliance and intent of the 401 Water Quality Certification and Buffer
Rules, the pro n n specifications, and othersupporting rr�terials.
Signature � � � � Date: �,3f�pj'(��
AgenYs Certific ion
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: '
If this project was designed by a Certified Professional
I, , as a duly registered Professional (i.e.,
Engineer, Landscape Architect, Surveyor, etc.) 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.
Signature
Date
401 Oversightr'Express Review Pennittiny U=ii;
1650 Mail Seruiee Center; Raleigh: Verth Care,ina 27699-105�
�ocaiion: 2321 Crabtree Bivd., Raleigh, P�orth Caroli�a 276C4
Phone: [phone] t FAX: [phone]
Interret: http:!!h2o.erestate.nc.us/rcr,vetlands�
Registration No.
p ���Od�
D
MAY � 1 5 2015 .
An EGual Ouporiunity 1.affirrr:ative �.ciien Empiever � DENR • WATER RESOURCES
TRANSPORTATION PERMITTING UNIT
One
NorthCarolina
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