HomeMy WebLinkAbout20140339 Ver 1_Certification of Completion_20150904�
; ��
���
North Carolina �i�partmert Gf E�virorm�nt ard "�at��al P.esc�rces
Pat McCrory
Governor
NCDWR Project No.: Zol�{0339
Applicant: �C�4T '�!(!S
County: ��SO/1
John t. Skvarla. III
Secretary
Project Name: s� �S�O 9 ( T �ih /j%or� �d � '
Date of Issuance of 401 Water Quality Certi�cation: Oj�//D� yC
-�
Certi�cate 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 Transportation Permitting
Unit, North Carolina Division of Water Resources, 1650 Mail Service Center, Raleigh, NC, 27699-1650. This form
may be returned to NCDWR by the applicant, the applicant's authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
Applicaht's Certification
[, ✓. /'C. �oi�l�/J S, � E. , hereby state that, to the best of my abilities, due care and diligence
was used in the observation o 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, ther su ortin aterials.
Signature: , p Date: `� ���' l�
AgenYs Certifrcatio "
[, , 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:
Engineer's Certification
Partial Final
�, , as a duly registered Professional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the project for the
Permittee 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
Transporlation and Perrr�itting Und
1650 Niaif Service Center, P,aleigh, Noith Ca�olina 27099 1650
Location: 512 N. Salisbury St. Raleigh, Norfh Carolina 27604
Phon°: 919-807-6300 \ FAX: 919-733-1290
internet: www.ncwaterqualifV.orq
:�n Equal Gpportunify'' J+ifrinative Achon Einploy2r
Registration No.
D �����%�
�
SEP - 4 2015
DENR -b'VATER RESOURCES
7RANSPORTATION PERMITTING UNIT
NorthCarolina
��tt�r��ll�
.. .,�
.i`� . ��f.4