20230896 Ver 1_Wagner CERTIFICATE OF COMPLETION

CERTIFICATE OF MPLETIMN
NCDWR Project No.: �
Applicant:
Project Name:
County: Q
:,
crate of issuance of 401 Water Quality Certification: S 1 0
Certificate of Completion
Upon completion of all work approved within the 401 Water Quality Certiflcat"vn or app[itable Buffer
Rules, and any subsequentmodifications, the applicant is required to return this certificate to the 401
Wetland & Buffer Permitting Unit, North Carolina Division of Water Resoardes, 1617 MMil Servici� Center,
Raleigh, NC, 27699-1617. 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.
Appllcones CertfCutlon ,
11 P
!!: ereby state that, to the best of myabilities, due care
and diligence was used i the observation of the construction suchthatthe rghstrudion was observed
to be built withirt'substantial compliance and intent of the 401 Water Quality Eertificatlorl and Buffer
Rules, the approved plans and specifications, and o her supporting materials.
< Date: - -�
Signature:
Agerrf's Certihffmtlon
y j4, q hereby.state that, to the best.ofmy abilities, due care
and diligence was use4 in the observati n 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 ecifications, and other supporting materials.
Signature: , Date: 1�
Engineer's Cert1ficotiot+
Partial Final
I 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
}clans and specifications, and other supporting materials.
Signature
Registration No. Date
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7D4.663. 1699