20130935 Ver 1_Certification of Completion_20150515

Beverly Eaves Ferdue
Govemoc
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North Carolina Department of Environment and Natural Resources
Division of Water Quality
Coieen H. Suliirs
Director
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DWQProjectNo.: zot3 Oq3S County: �wt�e
Applicant: �tc,o�7'
Project Name: g�, S3 ,,., 5�. 1� Z3 0� er 5�.•�� C.r��1�
Date of Issuance of 401 Water Quality Certification: 4��o�i3
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.
Applicant's Certification
I, �.(,Z., Npo��, n�, Q� , 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 n an peci i ations, and other supporting materials.
Signature: ,�a ° Date: z/( e /l�
v r,-----
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: �
If this project was designed by a Certified Professional
I, , as a duly registered P.rofessional (i.e:,
Engineer, Landscape Architect, Surveyor, etc:) in the State of North Carolina, having been autllorized
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 OversightrEx�ress Review Pe�riitting Unit
9650 (vtail Szrvice Center, Raleigh: North Garoline 2759�-1050
Location: 2321 Crabtree Bfvd., Raleigh, North Carolina 27604
Phone: [phone] FAX: 919 ?33-6893
Internet: hY�p:{?h2o.encsta�e.nc.usrncvetlandsl
Registration No.
S ������
D
fv9AY �. 5 2015
DENR • WATER RESOURCES
A.n cGual 0^por;unity `, ?.ffirmative Aciicn Emp!cyer , YRANSPORTATION PERMITTING UNil
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NorthCaral_ina
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