20130300 Ver 1_Certification of Completion_20150515

Qeverly Eaves ^rertlue
Governor
F�.�
_�_ E �
North Carolina Department of Environment and Natural Resources
Divisior�-of 1Nater Quality
J Coleen H. Sullins
Director
DWQProjectNo.: 2�13 v3oJ County: Pe��/�
Applicant: N � D ��
ProjectName:1, ���� 31 uu<r- f}I�n�'o,� Cr�ck ��.5
. Date of Isst�ance of 401 Water Quality Certification: 6(24
Dee Freeman
Secretary
�'`�' � y
Certificate of Completion
Upon completion of all work approved within the 401 Water.Quality Certification o►• applicable Buffer
Rules, and a�ry subsequent-modifications, the applicant.is required to return this certificate to the
401/Wetlands Unit, Noi-th Carolina Division of Water Qiiality, 1650 Mail Service Center, Raleigh, NC,
27699-1650. This form may be i•eturned to DWQ by the applicant, the applicant's authorized agent, or
the project engineer. It �is not ilecessary to send certificates from all of these.
App/icant's Certification
,I 5' � Q, H�Qki nS, P 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, tl�e appro � an d s cif atiqns, and other supporting materials.
Signature: Date: 2( c t3 (��
Agent's Certificatio
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 suppoi-ting materials.
Signature: ' Date:
If this project was designed by a Certified Professional
I, , as a duly registered Professional (i.e.,
Engineer, Landscape Architect, Surveyot�, 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 tlie 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 Ce►-tification and Buffer Rules; the app��oved plans and specifications, and other,
supporting materials.
Signature Registration No.
Date
401 Oversight/Express Review Permitting Unit
1650 Pateil Service Genter, Raleigh: Norfh Caro!ina 27F.99-1650
Location: 2321 Crabtree Bivd., Raleigh, �lo�ih Garofna 27604
Phone: 91?-733-1786 \ FAX: [phone]R9?
Internet: iittp:iih?o.enr.staie.nc.uslnaveflards/
An cqual Ocporunity?. r\Hinr:a�ive Action Emplc/et
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DENR • WATER RESOURCES
7RANSPORTATION PERMITTING UNIT