20150603 Ver 1_Approval Letter_20150821

NCDENR
North Carolina Department of Environment and Natural Resources
Pat McCrory Donald R. van der Vaart
Governor Secretary
August 21, 2015
D W R N 15 -0603
Mitchell County
Van F. Phillips Richard Baker
Spruce Pine Shopping Center, LLC; Great Meadows, Inc. Baker Family Partnership Ltd.
P.O. Box 400 11827 S. 226 Hwy
Spruce Pine, INC 28777 Spruce Pine, NC 28777
Roger and Mary Pittman
973 Carters Ridge Road
Spruce Pine, NC 28777
Starli. McDowell
Toe River Valley Watch
P.O. Box 252
Penland, NC 28765
GAP Corp. C/O Spruce Center Assoc., L.P.
P.O. Box 20847
Greensboro, NC 20847
Subject: APPROVAL OF 401 WATER QUALITY CERTIFICATION WITH ADDITIONAL CONDITIONS
Grassy Creek Stream Enhancement
Dear Mr. Phillips, Mr. Baker, Mr. and Mrs. Pittman, and Ms. McDowell:
You have our approval for the impacts listed below for the purpose described in your application dated June
11, 2015, and received by the Division of Water Resources (Division) on June 18, 2015, with subsequent
information on August 7, 2015. These impacts are covered by the attached Water Quality General Certification
Number 3885 and the additional conditions listed below. This certification is associated with the use of
Nationwide Permit Number 27 once it is issued to you by the U.S. Army Corps of Engineers. Please note that
you should get any other federal, state or local permits before proceeding with your project, including those
required by (but not limited to) Sediment and Erosion Control, Non - Discharge, Water Supply Watershed, and
Trout Buffer regulations.
This approval requires you to follow the conditions listed in the enclosed certification (s) or general permit and
the following additional conditions:
Division of Water Resources— Asheville Regional Office
2090 US Him 70, Swannanpa, NC 28778
Phone: 828 - 296 -4500 \ FAx: [phone]
Internet http: / /ponal.ncdenr.org /web /wq /ws
An Equal Opportunity \Affirmative Action Employer

Grassy Creek Stream Enhancement
OW R# 15 -0603
401 APPROVAL
Page 2 d 5
1. The following impacts are hereby approved provided that all of the other specific and general
conditions of the Certification are met. No other impacts are approved, including incidental impacts.
[15A NCAC 02H .0506(b) and /or (c)]
Type of Impact Amount Approved
(units)
Permanent
I Streams
Impact S1
Impact S2
Impact S3
Impact S4
Impact S5
Impact S6
404/401 Wetlands
Impact W1
288.5 linear feet
743.6 linear feet
2,118.1 linear feet
153.5 linear feet
34.5 linear feet
34.5 linear feet
0.036 acres
Amount Approved
(units)
Temporary
2. This approval is for the purpose and design described in your application. The plans and specifications
for this project are incorporated by reference as part of the Certification /Authorization. If you change
your project, you must notify the Division and you may be required to submit a new application
package with the appropriate fee. If the property is sold, the new owner must be given a copy of this
approval letter and General Certification(s) and is responsible for complying with all conditions. [15A
NCAC 02H .0507(d)(2)]
3. This authorization exempts the Permittee from meeting Condition H7 (Work in the Dry) in the attached
general certification for the placement of in- stream structure material into Grassy Creek. The
Permittee shall take all reasonable measures to construct in- stream structures while keeping heavy
equipment out of the stream channel. Stream flow will be diverted around work areas as much as
practicable. All reasonable steps must be taken to limit the amount of disturbance in the channel and
to therefore reduce downstream turbidity during construction. This exemption does not relieve the
Permittee of meeting stream standards as indicated in 15A NCAC 02B. [15A NCAC 02H .0506(f)]
4. The designer or his designee shall supervise the installation of in- stream structures. [15A NCAC 02H
.0506(b)(2)]
5. Native vegetation shall be used throughout this project. All tree and shrub plantings within the
proposed planting buffer on both sides of the stream shall be protected from mowing or clearing.
[15A NCAC 02H .0506(b)(2)]
6. Natural fiber matting is recommended for streambank stabilization over plastic matting that can entrap
small animals. [15A NCAC 02H .0506(b)(2)]

Grassy Creek Stream Enhancement
DW R# 15 -0603
401 APPROVAL
Page 3 of 5
7. Stream bed habitat material, such as cobble and gravel, should be harvested from abandoned channels
and relocated to new channels to the maximum extent practicable. [15A NCAC 02H .0506(b)(2)]
8. Visual monitoring of the project shall be conducted at a minimum of quarterly for the first year or two
bankfull events (whichever is longer), and then annually until the site is stable (particularly after storm
events) and vegetation is successful. Any failures of structures, stream banks, or vegetation may
require future repairs or replacement, which requires coordination with the Asheville Regional Office
to ensure the stability and water quality of the stream and downstream waters. [15A NCAC 02H
.0506(b)(2) and (b)(3)]
9. The permittee shall ensure that mature trees within the buffer areas will be protected as much as
feasible during the construction of this project. [15A NCAC 02H .0506(b)(2)]
10. Water shall not be released into any new channels until the stream and banks are stabilized. [15A
NCAC 02H .0506(b)(3)]
11. All mechanized equipment operated near surface waters or wetlands will be regularly inspected and
maintained to prevent contamination of waters and wetlands from fuels, lubricants, hydraulic fluids
or other potential toxic chemicals. In the event of a hydrocarbon or chemical spill, the
permitee /contractor shall immediately contact the Division, between the hours of 8 am to 5 pm at the
Asheville Regional Office at 828.296.4500 and after hours and on weekends call [phone].
Management of such spills shall comply with provisions of the North Carolina Oil Pollution and
Hazardous Substances Control Act. [15A NCAC 02H .0506 (b)(3) and (c)(3), 15A NCAC 02B .0200 (3)(f),
and GS 143 Article 21A]
12. Appropriate measures should be installed prior to any land clearing activities to protect waters and
wetlands from turbidity and/ or sedimentation. These measures should be routinely inspected and
properly maintained, and excavated materials should be contained outside the wetland boundary. -
Excessive silt and sediment loads can have numerous detrimental effects on aquatic resources
including destruction of spawning habitat, suffocation of eggs, and clogging . of gills of aquatic species.
[15A NCAC 02H .0506.(b)(3) and (c)(3)]
13. All wetlands, streams, surface waters, and riparian buffers located within 50 feet of the construction
area on the project site shall be clearly marked (example- orange fabric fencing) prior to any land
disturbing activities and must be maintained on the property until the project phase is completed.
[15A NCAC 02H .0506 (b)(2) and (c)(2) and 15A NCAC 02H .0507 (c)]
This approval and its conditions are final and binding unless contested. [G.S. 143- 215.5]
This Certification can be contested as provided in Articles 3 and 4 of General Statute 150B by filing a written
petition for an administrative hearing to the Office of Administrative Hearings (hereby known as OAH) within
sixty (60) calendar days.

Grassy Creek Stream Enhancement
DW RN 15 -0603
403 APPROVAL
Page 4 of 5
A. petition form may be obtained from the OAH at htto: / /www.ncoah.com/ or by calling the OAH Clerk's Office
at (919) 431 -3000 for information. A petition is considered filed when the original and one (1) copy along with
any applicable OAH filing fee is received in the OAH during normal office hours (Monday through Friday
between 9:00am and 5:00pm, excluding official state holidays).
The petition may be faxed to the OAH at (919) 431 -3100, provided the original and one copy of the petition
along with any applicable OAH filing fee is received by the OAH within five (5) business days following the
faxed transmission.
Mailing address for the OAH:
If sending via US Postal Service:
Office of Administrative Hearings
6714 Mail Service Center
Raleigh, NC 27699 -6714
If sending via delivery service (UPS,
Fed Ex, etc):
Office of Administrative Hearings
1711 New Hope Church Road
Raleigh, NC 27609 -6285
One (1) copy of the petition must also be served to DENR:
Sam M. Hayes, General Counsel
Department of Environment and Natural Resources
1601 Mail Service Center
Raleigh, NC 27699 -1601

Grassy Creek Stream Enhancement
DWRk 15 -0603
401 APPROVAL
Page 5 of 5
This letter completes the review by the Division under section 401 of the Clean Water Act as described in 15A
NCAC 02H .0500. Please contact Andrew Moore at 828 - 296 -4684 or Andrew.W.Moore @ncdenr.gov if you
have any questions or concerns.
Sincerely,
G. Landon Davidson, P.G., Regional Supervisor
Water Quality Regional Operations
Asheville Regional Office
Enclosures: GC 3885
Certificate of Completion
cc: Jason Zink — Zink Environmental, PLLC (via email)
Tasha Alexander— USACE Asheville Regulatory Field Office (via email)
Andrea Leslie — NCWRC (via email)
Fred Walker — DEMUR (via email)
DW R ARO 401 files
DWR 401 and Buffer Permitting Unit
6: \WR \WQ \Mitche11\4016 \Nan- DOT\Grassy Creek Stream Enhancement\ APRVL. GmssyCreekStreamEnhancement.8 d1- 15.doc

Water Quality Certification No. 3885
GENERAL CERTIFICATION FOR $TfIEAM RESTORATION, ENHANCEMENT AND
STABILIZATION PROJECTS AND WETLAND AND RIPARIAN RESTORATION AND --
CREATION ACTIVITIES INCLUDIN-Q T)IOE E1- IGIBLE!FOR U.S. ARMY CORPS OF
ENGINEERS NATIONWIDE PERMIT klf_MBERS 13 @Ahill( STABILIZATIONI AND
27IWETLA D AND RIPARIAN .RESTORhkTION- . AND 'GREATIONI,
AND REGIONAL PERMIT 978000801BULKHEADS AND.RIPRAPI
AND. RIPARIAN AREA PROTECTION RULESiBUFFER RULESI
Water Quality Certification Number 3885 is issued in conformity with the requirements of Section
401, Public Laws 92 -500 and 95 -217 of the United States and subject to the North Carolina
Division of Water Quality Regulations in 15A NCAC 02H .0500 and 15A NCAC 02B.0200 for the
discharge of fill material to waters as described In 33 CFR 330 Appendix A (B) (13 and 27) and
Regional Permit 197800080 and for the Riparian Area Protection Rules (Buffer Rules) in 15A
NCAC 026,0200.
The State of North Carolina certifies that the specified category of activity will not violate
applicable portions of Sections 301, 302, 303, 308 and 307 of the Public Laws 92 -500 and
95-217 if conducted in accordance with the conditions hereinafter set forth.
Activities meeting any one (1) of the following thresholds or circumstances require written
approval for a 401 Water Quality Certification from the Division of Water Quality (the
"Division'T
a) All proposed fill or modification of wetlands and /or waters, including streams and
streambanks, regardless of the purpose of the restoration, enhancement, stabilization, or
creation activity, except for single and independent projects involving In- stream structures `
for the sole purpose of streambank stabilization, which are designed: based on current i
natural channel techniques, and do not exceed a total of three structures within 100 feet
or less of streambank; or
b) Any stream relocation;. or
e) Bank Stabilization projects qualifying for Nationwide Permit 13 for erosion protection
which utilize non - natural armoring such as riprap, gabionbaskets, deflection walls etc of
greater than 150 feet in streambank length; or
d) $ank Stabilzatton projectg qualifying for Nationwide Permit 13 for erosion protection - -
which utilize natural streambank sloping, vegetation, and other natural channel protection
techniques of greater than 500 feet of streambank length; or
e) Any impact associated with a Notice of Violation or an enforcement action for violation($)
of DWQ Wetland Rules (15A NCAC 02H •0500), Isolated Weiland Rules (15A NCAC 02H
.1300), DWQ. Surface Water or Wetland Standards, or Riparian Buffer Rules (15A NCAC
028 .0200); or
f) Any impacts to streams and/or buffers In the Nauss, Tar - Pamlico, or Catawba River
Basins or in the Randleman, Jordan or Goose Creek Watersheds (or any other basin or
watershed with Riparian Area Protection Rules [Buffer Rules] in effect at the time of
application) unless the activities are listed as EXEMPT" from these rules or a Buffer
Authorization Certificate is issued through N,C Division of Coastal Management (DCM)
delegation for "ALLOWABLE" activities.
In accordance with North Carolina General Statute 143.216 3D(e), written approval for a 401
Water Quality General Certification must Include the appropriate fee, If aproject also requires a
CAMA Permit, then one payment to both agencies shall be submitted and will be the higher of the
two fees.
Water Quality Certification No. 3885 1

Water Quality Certification No. 3885
Activities Included In this General Certification that do not meet one of the thresholds
listed above do not require written approval from the Division as long as they comply with
the Conditions of Certification listed below. If any of those Conditions cannot be met, then
written approval from the Division Is repaired. -
Conditions of Certification:
1. Activities shall meet the definitions design, and monitoring protocols specified within the US
Army Corps of Engineers Wilmington District Regulatory Guidance Letter(RGL02 -02) and
the Stream Mitigation Guidelines (April 2003) or any subsequent updates to these
documents.
2. No Impacts Beyond those Authorized in the Written Approval or Beyond the Threshold of Use
of this Certification
No waste, spoil, solids, or fill of any kind shall occur in wetlands, waters, or riparian areas
beyond the footprint of the impacts depicted in the Pre- Constructon Notification, as
authorized in the written approval from the Division or beyond the thresholds established for
use of this Certification without written authorization including incidental impacts. All
construction activities Including the design installation, operation and maintenance of
sediment and erosion control Best Management Practices shall be performed so that no
violations of state water quality standards statutes or rules occur Approved plans and
specifications for this project are incorporated by reference and are enforceable parts of this
permit
3. Standard Erosion and Sediment Control Practices
Erosion and sediment control practices must be in full compliance with all specifications
governing the proper design, installation and operation and maintenance of such Best
Management Practices and if applicable, comply with the specific conditions and
requirements of the NPDES Construction Stormwater Permit issued to the site:
a. Design, installation, operation, and maintenance of the sediment and erosion control
measures must be such that they, equal or exceed the requirements specified in the most
recent ve[sio0 of the North Carollna Sadlment and Erosion Confro7 Manual l`he devices
shell be maintained on all construction sites, borrow sites, and waste pile: (spoil) projects,
including contractor -owned or leased borrow pits associated with the project.
b. For borrow pit sites, the erosion and sediment control measures must be designed,
Installed, operated, and maintained in accordance with the most recent version of the
North Carolina Surface Mining Manual.
c. Reclamation measures and implementation must comply with the reclamation In
accordance with the requirements of the Sedimentation Pollution Control Act and the
Mining Act of 1971.
d. Sufficient materials required for stabilization and /or repair of erosion control measures
and stormwater routing and treatment shall be on site at all times.
e. If the project occurs in waters or watersheds classified as Primary Nursery Areas.(PNAs),
SA WS -I, WS -II High Quality (HOW), or Outstanding Resource (ORW) waters, then the
sedimentation and erosion control designs must comply with the requirements set forth
in 15A NCAC 04B,.0124,. Design Standards in Sensitive Watersheds,
Water Quality Certification No. 3886 2

Water Quality Certification No. 3885
4. No Sediment and Erosion Control Measures in Wetlands or Waters
Sediment and erosion control measures shall not be placed in wetlands or waters.
Exceptions to this condition require application submittal to and written approval by the
Division,: If placement of sediment and erosion control devices in wetlands and waters is
unavoidable, then design and placement of temporary erosion control measures shall not be
conducted in a manner that may result In.dls- equilibrium of wetlands, stream beds, or banks,
adjacent to or upstream and downstream of the above structures.. All sediment and erosion
control devices shall be removed and the natural grade restored within two (2) months of the
date that the Division of Land Resources (DLR) or locally delegated program has released
the specific area within the project.
5, Construction Stormwater Permit NOG010000
An NPDES Construction Stormwater Permit is required for construction projects that disturb
one (1) or more acres of land. This Permit: allows stormwaterto be discharged during land
disturbing construction activities as stipulated in the conditions of the permit. If your project
is covered by this permit, full compliance with permit conditions including the erosion 8
sedimentation control plan, inspections and maintenance, self - monitoring, record keeping
and reporting requirements is required. A copy of the general permit.(NCG010000)I
inspection log . sheets, and other information may be found at
htto:lioortal.ncdenr.ora/webiwo/ws/su/nDdessw#tabw.
The North Carolina Department of Transportation (NCQOT)shall be.. required to be in full
compliance with the conditions related to construction activities within the most recent version
of their individual NPDES (NCS000260) stormwalerpermit.
6. Construction Moratoriums and Coordination
If activities must occur during periods of high biological activity (i.e. sea turtle nesting, fish
spawning, or bird nesting), then biological monitoring may be required at the request of other
state or federal agencies and coordinated with these activities.
(Di or National Marine Fisheries Service (NMFS) to lessen impacts on trout, anadromous
fish larval /post - larval fishes: and crustaceans, or other aquatic species of concern shall be
implemented. Exceptions to this condition require written approval by the resource agency
responsible for the given moratorium.
Work within the twenty -five (25) designated trout counties or identified state or federal
endangered or threatened species habitat shall be coordinated with the appropriate WRC,
VSFWS, NMFS,_and /or DMF personnel.
Z Work in the Dry
All work in or adjacent to stream waters shall be conducted so that the flowing stream does
not come in contact with the disturbed area. Approved best management . practices from the
most current version of the NC Sediment and Erosion Control Manual, or the NC DOT
Construction and Maintenance Activities Manual such as sandbags, rock berms, cofferdams,
and other diversion structures shall be used to minimize excavation in flowing water.
Exceptions to this condition require application submittal to and written approval by the
Division.
Water Quality Certification No. 3885

Water Quality Certification No. 3885
8. Riparian Area Protection (Buffer) Rules
Activities located In the protected riparian areas (whether jurisdictional wetlands or not),
within the Nauss, Tar - Pamlico, or Catawba River Basins or in the Randleman, Jordan, or
Goose Creek Watersheds (or any other basin or watershed with buffer rules). shall be limited
to "uses identified within and constructed in accordance with 15A NCAC 02B.0233, .0259,.
.0243 0250, .0267 and .0605, and shall be located designed, constructed, and maintained
to have minimal disturbance to protect water quality to the maximum extent practicable
through the use of best management practices. All buffer rule requirements, including diffuse
flow requirements, must be mat.
9, if concrete is used during the construction, then all necessary measures shall be taken to
prevent direct contact between uncured or curing concrete and waters of the state. Water
that inadvertently contacts uncured concrete shall not be discharged to waters of the state
due to the potential for elevated fill and possible aquatic life/ fish kills.
10. All temporary fill and culverts shall be removed and the Impacted area returned to natural
conditions within 60 days of the determination that the temporary impact is no longer
necessary. The impacted areas shall be restored to original grade, including each stream's
original cross sectional dimensions, plan form pattern and longitudinal bed and bed profile,
and the various sites shall be stabilized with natural woody vegetation (except for the
approved maintenance areas) and restored to prevent erosion
91. All temporary pipes/ culverts / . riprap pads etc, shall be installed in all streams as outlined in
the most recent edition of the North Carolina Sediment and Erosion Control Planning and
Design Manual or the North Carolina Surface Mining Manual so as not to restrict stream flow
or cause dis- equilibrium during use of this General Certification.
12. Any riprap required for proper culvert placement, stream stabilization, or restoration of
temporarily disturbed areas shall be restricted to the area directly Impacted by the approved
construction activity All rip -rap shall bused and /or "keyed in" such that the original stream
elevation and streambank contours are restored and maintained Placement of rips -rap or
other approved materials shall not result In de- stabilization of the stream bettor banks
upstream or downstream of the area.,
13. Any rip -rap used for stream stabilization shall be of a size and density so as not to be able to
be carried off by wave, current action, or stream flows and consist of clean rock or masonry
material free of debris or toxic pollutants. Rip -rap shall not be installed in the streambed
except in specific areas required for velocity control and to ensure . structural integrity of bank
stabilization. measures.
14. A one -time application of fertilizer to re- establish vegetation is allowed in disturbed areas
including riparian buffers, but Is restricted to no closer than I D feet from top of bank of
streams. Any fertilizer application must comply with all other Federal, State and Local
regulations.
15. Applications for riprap groins proposed in accordance with 15A NCAC 07H .1401. INC
Division of Coastal Management General Permit for construction of Wooden and Riprap
Groins in Estuarine and Public Trust. Waters) must meet all the specific conditions for design
and construction specified in 15A. NCAC' 07H .1405.
Water quality Certification No. 3886

Water Quality Certification No. 3885
16. Compensatory Mitigation
In accordance with 15A NCAC 02H..0506 (h), compensatory mitigation may be required for
losses of equal to or greater than 150 linear feet of streams (intermittent and perennial)
and /or equal to or greater than one (1). acre of wetlands. For linear public transportation
projects, impacts equal to or exceeding 150 linear feet per stream shall require mitigation.
Buffer mitigation may be required for any project with Buffer Rules in effect at the time of
application for activities classified as "Allowable with Mitigation" or "Prohibited" within the
Table. of Uses.
Adetermination of buffer, wetland, and stream mitigation requirements shall be made for any
General Water Quality Certification for this Nationwide and/or Regional General Permit.
Design and monitoring protocols shall follow 'the US Army Corps of Engineers Wilmington
District Stream Mitigation Guidelines (April 2003) or its subsequent. updates. Compensatory
mitigation plans shall be submitted to the Division for written approval as required in those
protocols. The mitigation plan must be implemented and /or constructed before any impacts
occur on site. Alternatively, the Division . will accept payment into an in -lieu fee program or
mitigation bank. In these cases, proof of payment shall be provided to the Division before
any impacts occur on site.
17. If an environmental document is required under the National or State Environmental Policy
Act (NEPA or SEPA), than this General Certification is not valid. until Finding of No
Significant Impact(FONSI) or Record of Decision (ROD) is issued by the State
Clearinghouse,
18. In the twenty (20) coastal counties, the appropriate DWQ. Regional Office must be contacted
to determine if Coastal Stormwater Regulations . will be required.
19.. This General Certification does not relieve the applicant of the responsibility to obtain all other
required Federal, State, or Local approvals.
20. The applicam/permiltee and their authorized agents shall conduct all activities In a manner
State and Federal Law. If the Division determines that such standards or laws are not being
met, including failure to sustain a designated or achieved use, or that State or Federal law is
being violated, or that further conditions are necessary to assure compliance, then the
Division may reevaluate and modify this General Water Quality Certification.
21. When written authorization is required for use of this certification, upon completion of all
permitted impacts included within the approval and any subsequent modifications, the
applicant shall be required to return the certificate of completion attached to the approval.
One copy of the certificate shall be sent to the DWQ Central Office. in Raleigh at 1650 Mail
Service Center, Raleigh, NC, 27699.1650.
22. Additional site - specific conditions, including monitoring and /or modeling requirements, may
be added to the written approval letter for projects proposed under this Water Quality
Certification in order to ensure compliance with all applicable water quality and effluent
standards.
23.. This certification grants permission to the director, an authorized representative of the
Director, or DENR staff, upon the presentation of proper credentials, to enter the property
during normal business hours..
Water Quality Certification No. 3885

Water Quality Certification No. 3885
This General Certification shall expire on the same day as the expiration date of the
corresponding Nationwide and /or Regional General Permit. The conditions in effect on the date
or issuance of Certification fora specific project shall remain in effect for the life of the project,
regardless of the expiration date of this Certification.
Non - compliance with or violation of the conditions herein set forth by a specific project may result
in revocation of this General Certification for the project and may also result in criminal and /or civil
penalties.
The Director of the North Carolina Division of Water Quality may require submission of a formal
application for Individual Certification for any project in this category of activity if it is determined
that the project is likely to have a. significant adverse effect upon water quality, Including state or
federally listed endangered or threatened aquatic species, or degrade the waters so that existing
uses of the wetland or downstream waters are precluded.
Public hearings may be hold for specific applications . or group of applications prior to a
Certification decision if deemed in the public's best interest by the Director of the North Carolina
Division of Water Quality.
Effective date: March 19, 2012
DIVISION OF WATER QUALITY i
i
By
Charles Waklid, P.E. f
Director
I
History Note; Water Quality Certification (WQC) Number 3885 issued March 19, 2012 replaoes
WQC Number 3689 issued November 1, 2007; WQC Number 3626 issued March, 2007, WQC
Number 3495 issued December 31, 2004; and . WQC Number 3399 issued March 2003. This
General Certification is rescinded when the Corps of Engineers reauthorizes any of the
corresponding Nationwide and/or Regional General Permits and /or when deemed appropriate by
the Director of the Division: of Water Quality. '..
I
Water Quality Certification No. 3885 6

A T�IR
North Carolina Department of Environment and Natural Resources
Pat McCrory
Governor
Donald R. van der Val
Secretary
DWRProject No.: County:
Applicant:
Project Name:
Date of Issuance of 401 Water Quality Certification:
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 and Buffer Permitting Unit, North
Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh, NC, 27699 -1650. This form may be returned to
DWR 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, , hereby state that, to the but 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:
Agent's CertPcation
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 th is project was designed by a Certified Profession at
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 Petmitee 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: Registration No.
Date
4018 Buffer Penns ling Unit
1650 Mail Senrlie Center, Ralegh, Noah Carolina 276991650
Phone: 9IM0763001 FAX: [phone]
Informer hdp:llportarnadenrorpheelvel
qtr Equal oppo mmily l Afflaalse Aden Employer