20110517 Ver 1_Certification of Completion_20150617

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J U N g 7 2015 �'��� -
' DENR - WATER RESOUftGES N�D�., \1`
TRANSPORTATION�ORqi1 Lar011na Department af Environment and Natural Resources
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Division of Water Quality
Beverly Eaves Perdue Coleen H. Su{lins
Governor Director
DWQ Project No.: ?i6�/ Ogt7
Applicant: N�- 17��
County: (�`�'`�T��°f�
ProjectName: $ iZ �735 r3r'i�" Gr�`� 2°�`Q
Date of Issuance oT401 Water Quality Certification: �uKC_ Z.� T�i�
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Dee Freeman
Secretary
Certificate of Completioo
Upon eompletion of akl worlc approved within the 4pl Water Qualiry Certification or applicable Buffer Rules, and
any subsequent modifications, the applicant is required to return this certiFicate to the 401 Transportation Permitting
Unit, %lorth Carolina Division of Water Quality, 165Q Mail Service Center, Rafeigh, NC, 27699-i650. This fonn
may be returned to DWQ by the applicant, the applicant's authorized agent, or the pro}ect engineer. lt is not
necessary to send certificates from a!1 of these.
Applicant�C�rtificatio�JG
I, G S�'�[ � , 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
compiiancc and intent of thz 4C I Water Quality Certification and Buffer Rules, the approved plans and
specifi�ations, and other supporting materials.
Sianature: L�%�*— C:at2� �C �%� •►e. �5
Agent's Certification
�, , hereby state that, tb the best of my abifities, due care and diligence
was ased in the observation of the construction such that the constraction 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 materiafs, �
Signature: Date:
Gngineer's Certification
Partial Final
�, , as a duly registered Professionai Engineer in the State of Norch
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project,for the
Permittee hereby.state tha[, to the best of my abilities, due care and diligence was used in the observation of the
construction such that the const�uction was observed to be built within substantial campliance and intent of the 401
Water Quafity Certification and 8uffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No.
Date
1617 Mail Service CentBr, Raleigh, Norlh Carolina 21699-5 6 1 7
Locatlon: 512 N. Sallsbury St. Raleigh, Nodh Carolina 27604 �n�
Phone: [phone] FAX: [phone] Customer Service:l•877�23-6748 NorthCarolina
{nternet: www.navaterquality.org ��tur�ll�
An Equal Opportunily l A�rmaGve Aclion Employer