HomeMy WebLinkAbout20111101 Ver 2-_Certification of Completion_20160401�• �
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Wate�Resources
ENVIRONMENTAL �UALITY
PAT MCC120RY
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DONALD R. VAN DL'R VAART
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S. JAY T.IMMERMAN
Dpeanir
NCDWRProjectNo.:O��I���I, I����L3%� County: `�•��Pi`Sdj'�-
Applicant: _/I�G-,ti0,�
ProjectName: /�,-'J�.�D%.�i �i(� �d�li � /`fb �z-roG ��
Date of Issuance of 40l Water Quality Certification: �'�02 3��02
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 ro return this certificate ro the 401 Transportation Permitting
Unit, North Carolina Divisian of Water Resources, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be retumed to NCDWR by the applicant, the applicanYs authorized agent, or the projec[ engineer. It is not
necessary to send certificates from all of these.
ApplicmiPs Certificntion
I, �j,�K `j •(/�z✓/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 canstruc[ion was observed to be built within substantial
compliance and intent of the 401 Water Quali Certification and Buffer Ru(es, the approved plans and
specifications, and other supportine materi .
Signature: ` Date: �'����{p
Agent's C�r/rficr.liaa
� , 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 40l Water Quality Certification and Buffer Rules, the approved plans and
specifications, and other supporting materials.
Signature:
Edgi��eer's Cer�rficnliau
Partial Final
� , as a duly registered Professional Engineer in the Sta[e of North
Carolina, having been authoriud [o observe (periodically, weekly, full time) the construction of the projec[ 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 d�e 401
Water Quality Certification and Buffer Rules, the approved plans and specifications, and other supporting materials.
Signature Registration No.
Date
Stale of.�'onh Camiina IEn.9mnmeNal Quality I Wmcr Resources
����od��
APR - 1 2016
DENR-WATERRESOURCES
TRANSPORTATION PERMITTING UNIT
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Water Resources
ENVIRONMENTAL �UALITY
NCDWR Praject No.:
Applicant: _ 7�G�
Project IYame:
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PA9' MCCRORY
Gmxinnr
DONALD R. VAN DL'lt VAART
srt�rcrnr��
S. JAY 7.IMMERMAN
UUtt4.r
C011llfy: �/Lrtipl�/50✓L-
Date of Issuance of 40( Water Quality Certification: a�- � r.2P ���
Certificate of Completion
Upon completion of all work approved within the 40I 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, 1617 Mail Service Center, Raleigh, NC, 27699-1617. This form
may be reiurned to NCDWR by the appiicant, the applicanYs authorized agent, or the project engineer. It is not
necessary to send certificates from all of these.
ApplicanYs CerliJlcntion
I�1�%u/L ��/�z�/,� , hereby state that, ro the hest 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 ertification and Buffer Rules, the approved plans and
specifications, and other supportina m� terials
Signature: a� Date: ����'��
AgeriPs Cerlificr.lio::
� , 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, [he approved plans and
specifications, and other supporting materials.
Signamre:
Engineer's Cerlifrcnlian
Partial Final
� , as a duly registered Profesional Engineer in the State of North
Carolina, having been authorized to observe (periodically, weekly, full time) the construction of the projec[ for the
Permittee hereby state that, to the best of my a6ilities, due care and diligence was used in the observation of the
construction such that the construction was observed ro be built within substantial compliance and intent of theA01
Water Quality Certification and Buffer Rules, [he approved plans and specifications, and otfier supporting materials.
Date
Registration No.
Sta1e of Nonh Caroiina �Envimnmenlal Quality � Water Remnrcea
7617 Mail Service CenteC Raieigh, Notlh Camlina 27699-16ll
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111� IJ
APR — 1 2016
DENR•WAPERRESOURCES
7RANSPOtiTATION.PERMITTING UNIT